Provider Demographics
NPI:1275700353
Name:BARTON, KATHY A (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:A
Last Name:BARTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8111 NEW BRADFORD BLVD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-1107
Mailing Address - Country:US
Mailing Address - Phone:586-268-8165
Mailing Address - Fax:248-689-4325
Practice Address - Street 1:8111 NEW BRADFORD BLVD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-1107
Practice Address - Country:US
Practice Address - Phone:586-268-8165
Practice Address - Fax:248-689-4325
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010182761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOMO2730Medicare PIN