Provider Demographics
NPI:1649746165
Name:BARTON, JOAN LUCILLE (MA)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:LUCILLE
Last Name:BARTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 OAK SPRINGS PL
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4729
Mailing Address - Country:US
Mailing Address - Phone:407-221-3292
Mailing Address - Fax:
Practice Address - Street 1:1325 OAK SPRINGS PL
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3274
Practice Address - Country:US
Practice Address - Phone:407-221-3292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB635482718460OtherDL