Provider Demographics
NPI:1225620172
Name:BARTLETT, ANNE (LSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 COUNTY ROAD 250
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-6976
Mailing Address - Country:US
Mailing Address - Phone:970-799-3522
Mailing Address - Fax:
Practice Address - Street 1:1309 E 3RD AVE UNIT 10
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5251
Practice Address - Country:US
Practice Address - Phone:970-799-3522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0009923273104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker