Provider Demographics
NPI:1336703248
Name:BARTHELEMY, LAURE (CBHCM)
Entity Type:Individual
Prefix:MRS
First Name:LAURE
Middle Name:
Last Name:BARTHELEMY
Suffix:
Gender:F
Credentials:CBHCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 CARAMEL AVE APT 136
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-6614
Mailing Address - Country:US
Mailing Address - Phone:386-341-4999
Mailing Address - Fax:
Practice Address - Street 1:533 N NOVA RD STE 204
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-4422
Practice Address - Country:US
Practice Address - Phone:386-898-5003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator