Provider Demographics
NPI:1477368991
Name:BARTOK, CHRISTA (MSW)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:BARTOK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 W IDLEWILD AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-6500
Mailing Address - Country:US
Mailing Address - Phone:727-420-4872
Mailing Address - Fax:
Practice Address - Street 1:9304 CAMDEN FIELD PKWY
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-0520
Practice Address - Country:US
Practice Address - Phone:813-670-3918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW183551041C0700X
FL15328091041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical