Provider Demographics
NPI:1649693623
Name:BARTLEY, JAMES L JR (MSW, LMHP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:BARTLEY
Suffix:JR
Gender:M
Credentials:MSW, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 L ST
Mailing Address - Street 2:
Mailing Address - City:ORD
Mailing Address - State:NE
Mailing Address - Zip Code:68862-1275
Mailing Address - Country:US
Mailing Address - Phone:308-728-4200
Mailing Address - Fax:308-728-5779
Practice Address - Street 1:110 S 26TH ST
Practice Address - Street 2:
Practice Address - City:ORD
Practice Address - State:NE
Practice Address - Zip Code:68862-1240
Practice Address - Country:US
Practice Address - Phone:308-728-4200
Practice Address - Fax:308-728-5779
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE137OtherSTATE OF NE LICENSE NUMBER
NE3708OtherNEBRASKA LMHP