Provider Demographics
NPI:1134186638
Name:EM BARTLINSKI & ASSOCIATES
Entity type:Organization
Organization Name:EM BARTLINSKI & ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BARTLINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, LCADC
Authorized Official - Phone:410-761-0725
Mailing Address - Street 1:CRAIN STATION 5 CRAIN HWY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-2803
Mailing Address - Country:US
Mailing Address - Phone:410-761-0725
Mailing Address - Fax:410-761-2412
Practice Address - Street 1:5 CRAIN HWY N, 2ND FLOOR
Practice Address - Street 2:CRAIN STATION
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2803
Practice Address - Country:US
Practice Address - Phone:410-761-0725
Practice Address - Fax:410-761-2412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2002101Y00000X
MDLCA134101YA0400X
MDSC2109101YA0400X
MDLC1371101YA0400X, 101YM0800X
MDLC4453101YA0400X
MD11957104100000X
MD03285104100000X
MD11975104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD133131100Medicaid
M0830000OtherCAREFIRST
MDH285M199Medicare PIN
MDH285N496Medicare PIN
MDH285H507Medicare PIN
MDH285L955Medicare PIN
M0830000OtherCAREFIRST