Provider Demographics
NPI:1386027449
Name:BARTON, KELLIE (PHD, LCP, LCAC)
Entity Type:Individual
Prefix:DR
First Name:KELLIE
Middle Name:
Last Name:BARTON
Suffix:
Gender:F
Credentials:PHD, LCP, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 HAPPY HOLLOW ST
Mailing Address - Street 2:
Mailing Address - City:VERMILLION
Mailing Address - State:KS
Mailing Address - Zip Code:66544-8633
Mailing Address - Country:US
Mailing Address - Phone:785-363-6012
Mailing Address - Fax:785-363-6013
Practice Address - Street 1:309 HAPPY HOLLOW ST
Practice Address - Street 2:
Practice Address - City:VERMILLION
Practice Address - State:KS
Practice Address - Zip Code:66544-8633
Practice Address - Country:US
Practice Address - Phone:785-363-6012
Practice Address - Fax:785-363-6013
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2618101Y00000X
KS748101YA0400X
KS1503103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)