Provider Demographics
NPI:1720250038
Name:BARTKOWIAK, CHRIS (LMHC)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:
Last Name:BARTKOWIAK
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2342 PARK ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4318
Mailing Address - Country:US
Mailing Address - Phone:904-384-4910
Mailing Address - Fax:904-389-9220
Practice Address - Street 1:2342 PARK ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4318
Practice Address - Country:US
Practice Address - Phone:904-384-4910
Practice Address - Fax:904-389-9220
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5877101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health