MEDICARE: JOHN C BARTLEY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245242627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN C BARTLEY LCSW

Provider Business Mailing Address
First Line	:	PO BOX 1298
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77501-1298
Country	:	US
Telephone Number	:	832-672-6318
Fax Number	:	832-672-6319

Provider Business Practice Location Address
First Line	:	4001 PRESTON AVE
Second Line	:	STE 145
City	:	PASADENA
State	:	TX
Zip	:	77505-2062
Country	:	US
Telephone Number	:	832-672-6318
Fax Number	:	832-672-6319

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	06/14/2023

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Directions to “ JOHN C BARTLEY LCSW” Practice Location

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