Provider Demographics
NPI:1417359225
Name:BARTELS, KATHERINE ANN
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:BARTELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NE
Mailing Address - Zip Code:68787-1717
Mailing Address - Country:US
Mailing Address - Phone:402-360-1704
Mailing Address - Fax:
Practice Address - Street 1:212 SHERMAN ST
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NE
Practice Address - Zip Code:68787-1717
Practice Address - Country:US
Practice Address - Phone:402-360-1704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10359101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health