Provider Demographics
NPI:1710768957
Name:BARTELS, ABIGAIL NICOLE (BS, MA)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:NICOLE
Last Name:BARTELS
Suffix:
Gender:F
Credentials:BS, MA
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:NICOLE
Other - Last Name:BARTELS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16 CRESCENT RD APT 1619J
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5828
Mailing Address - Country:US
Mailing Address - Phone:765-760-6004
Mailing Address - Fax:
Practice Address - Street 1:16 CRESCENT RD APT 1619J
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5828
Practice Address - Country:US
Practice Address - Phone:765-760-6004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451023264101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health