Provider Demographics
NPI:1407287428
Name:BARTH, NICHOLAS C (LMFT)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:C
Last Name:BARTH
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6806
Mailing Address - Country:US
Mailing Address - Phone:360-389-2258
Mailing Address - Fax:360-714-8355
Practice Address - Street 1:1129 LENORA CT
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6816
Practice Address - Country:US
Practice Address - Phone:360-389-2251
Practice Address - Fax:360-714-8355
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-01
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60925040106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA20190521305669Medicaid