Provider Demographics
NPI:1578108395
Name:BARTLETT, DONNA ANN (LSW)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:ANN
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0S323 PARK ST
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1416
Mailing Address - Country:US
Mailing Address - Phone:630-674-8009
Mailing Address - Fax:
Practice Address - Street 1:1415 BOND ST STE 127
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2769
Practice Address - Country:US
Practice Address - Phone:630-355-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150103991104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker