Provider Demographics
NPI:1518340702
Name:BARTA, MINDI JEAN (LPC, MA)
Entity Type:Individual
Prefix:
First Name:MINDI
Middle Name:JEAN
Last Name:BARTA
Suffix:
Gender:F
Credentials:LPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 COUNTRY CLUB RD STE 222
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2238
Mailing Address - Country:US
Mailing Address - Phone:541-686-6000
Mailing Address - Fax:
Practice Address - Street 1:921 COUNTRY CLUB RD STE 222
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2238
Practice Address - Country:US
Practice Address - Phone:541-686-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3787101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional