Provider Demographics
NPI:1932322757
Name:BARTEL, SHELLEY LOUANN (LSCSW)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:LOUANN
Last Name:BARTEL
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 ASH ST.
Mailing Address - Street 2:SUITE100
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211
Mailing Address - Country:US
Mailing Address - Phone:913-696-1400
Mailing Address - Fax:913-696-1403
Practice Address - Street 1:11100 ASH ST
Practice Address - Street 2:SUITE100
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1925
Practice Address - Country:US
Practice Address - Phone:913-696-1400
Practice Address - Fax:913-696-1403
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW 9951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS74-2630036OtherIRS TAXPAYER ID NUMBER
KS0002254Medicare ID - Type Unspecified