Doctor Name: | AUDRA L BARTELT |
NPI Number: | 1093049421 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 34006710A |
Business Practice Address: | 121 Buntin St Ste 1 Vincennes, IN - 475911320 |
Business Phone Number: | 8128852718 |
Business Fax Number: | 8128852727 |
Mailing Address: | 515 Bayou St, VINCENNES |
State: | IN |
Postal Code: | 475911034 |
Phone Number: | 8128866800 |
Fax Number: | 8128866809 |
NPI Enumeration Date: | 10/02/2009 |
NPI Last Update Date: | 08/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 34006710A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |