Provider Demographics
NPI:1841947108
Name:BARTON, ELIZABETH ROSE (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ROSE
Last Name:BARTON
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ROSE
Other - Last Name:PASTUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29478 HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-3456
Mailing Address - Country:US
Mailing Address - Phone:586-489-3192
Mailing Address - Fax:
Practice Address - Street 1:8623 N WAYNE RD STE 123
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-1137
Practice Address - Country:US
Practice Address - Phone:734-367-0469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511112641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical