Provider Demographics
NPI:1366853988
Name:BARTZ, TERRY (ATR-BC, LPCMH)
Entity Type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:
Last Name:BARTZ
Suffix:
Gender:F
Credentials:ATR-BC, LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6451 REEF CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-3975
Mailing Address - Country:US
Mailing Address - Phone:813-388-0525
Mailing Address - Fax:
Practice Address - Street 1:6451 REEF CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-3975
Practice Address - Country:US
Practice Address - Phone:813-388-0525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-16
Last Update Date:2014-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000108101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health