Provider Demographics
NPI:1184197717
Name:BARTLETT, JESS (MSW)
Entity Type:Individual
Prefix:
First Name:JESS
Middle Name:
Last Name:BARTLETT
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 E 13TH ST STE E
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-7956
Mailing Address - Country:US
Mailing Address - Phone:918-791-9700
Mailing Address - Fax:
Practice Address - Street 1:1107 E 13TH ST STE E
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-7956
Practice Address - Country:US
Practice Address - Phone:918-791-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health