Provider Demographics
NPI:1740613082
Name:BARTELL, ELIZABETH (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BARTELL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 EXCHANGE ST STE 301
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-3364
Mailing Address - Country:US
Mailing Address - Phone:503-325-0241
Mailing Address - Fax:503-325-8483
Practice Address - Street 1:2120 EXCHANGE ST STE 301
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-3364
Practice Address - Country:US
Practice Address - Phone:503-325-0241
Practice Address - Fax:503-325-8483
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical