Provider Demographics
NPI:1568690196
Name:BARTLETT, LYNN ANN (LMSW-CLINICAL SUPERV)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ANN
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:LMSW-CLINICAL SUPERV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 W. DELAWARE
Mailing Address - Street 2:
Mailing Address - City:NOWATA
Mailing Address - State:OK
Mailing Address - Zip Code:74048
Mailing Address - Country:US
Mailing Address - Phone:918-273-1841
Mailing Address - Fax:918-273-1843
Practice Address - Street 1:114 W DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:NOWATA
Practice Address - State:OK
Practice Address - Zip Code:74048-2601
Practice Address - Country:US
Practice Address - Phone:918-273-1841
Practice Address - Fax:918-273-1843
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS75401041C0700X
OK39731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical