Provider Demographics
NPI:1457402943
Name:BARTLING, FAY R I (RN, LMHC, LADAC1)
Entity Type:Individual
Prefix:MS
First Name:FAY
Middle Name:R
Last Name:BARTLING
Suffix:I
Gender:F
Credentials:RN, LMHC, LADAC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-2910
Mailing Address - Country:US
Mailing Address - Phone:508-292-9055
Mailing Address - Fax:
Practice Address - Street 1:12 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-2910
Practice Address - Country:US
Practice Address - Phone:508-292-9055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4073101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health