Provider Demographics
NPI:1639232598
Name:BARTON-GODEC, CAROL ANN (PSYCHIATRIC CNS)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN
Last Name:BARTON-GODEC
Suffix:
Gender:F
Credentials:PSYCHIATRIC CNS
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Mailing Address - Street 1:5606 DUSTY CHAPS DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-4142
Mailing Address - Country:US
Mailing Address - Phone:719-550-9202
Mailing Address - Fax:719-550-8933
Practice Address - Street 1:6465 GREENWOOD PLAZA BLVD
Practice Address - Street 2:SUITE 300, CO030-1000
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4905
Practice Address - Country:US
Practice Address - Phone:888-795-7975
Practice Address - Fax:303-267-3179
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO75151364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO092678Medicaid
CO092678Medicaid