Provider Demographics
NPI:1275101222
Name:VANSLYKE-BARTLEY, MEGAN (LSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:VANSLYKE-BARTLEY
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:PO BOX 556
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-0556
Mailing Address - Country:US
Mailing Address - Phone:812-494-9501
Mailing Address - Fax:812-494-9502
Practice Address - Street 1:1901 WILLOW ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-4277
Practice Address - Country:US
Practice Address - Phone:812-885-2720
Practice Address - Fax:812-885-2723
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33011523A104100000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker