Provider Demographics
NPI:1831211085
Name:BARTLEY, LORI LYNN (MCP, LPC)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:LYNN
Last Name:BARTLEY
Suffix:
Gender:F
Credentials:MCP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 W. OWEN K GARRIOTT BUILDING #4
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703
Mailing Address - Country:US
Mailing Address - Phone:580-234-9233
Mailing Address - Fax:580-234-9256
Practice Address - Street 1:1420 W. OWEN K. GARRIOTT
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703
Practice Address - Country:US
Practice Address - Phone:580-234-9233
Practice Address - Fax:580-234-9256
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3576101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor