Provider Demographics
NPI:1841237716
Name:BARTLESON, JANICE (PHD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:BARTLESON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8827 STATE ROUTE 21
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:NY
Mailing Address - Zip Code:14512-9531
Mailing Address - Country:US
Mailing Address - Phone:585-374-9557
Mailing Address - Fax:
Practice Address - Street 1:8827 STATE ROUTE 21
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:NY
Practice Address - Zip Code:14512-9531
Practice Address - Country:US
Practice Address - Phone:585-374-9557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012039-1174400000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01595160Medicaid
NY02077181Medicaid
NYP010012039OtherBLUE CHOICE
NY02077181Medicaid