Provider Demographics
NPI:1740332725
Name:BARTOK, CATHERINE W (MS, LCPC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:W
Last Name:BARTOK
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:
Other - Last Name:BARTOK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:PO BOX 1054
Mailing Address - Street 2:
Mailing Address - City:WELLS
Mailing Address - State:ME
Mailing Address - Zip Code:04090-1054
Mailing Address - Country:US
Mailing Address - Phone:207-646-1147
Mailing Address - Fax:207-646-1147
Practice Address - Street 1:43 SANFORD RD.
Practice Address - Street 2:UNIT # 1
Practice Address - City:WELLS
Practice Address - State:ME
Practice Address - Zip Code:04090
Practice Address - Country:US
Practice Address - Phone:207-646-1147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC860101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health