Provider Demographics
NPI:1932591443
Name:BERTCH, BARBARA (MAMFC)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:
Last Name:BERTCH
Suffix:
Gender:F
Credentials:MAMFC
Other - Prefix:MRS
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:STARWALT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSE
Mailing Address - Street 1:2501 PARKVIEW DR
Mailing Address - Street 2:SUITE 312
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-5824
Mailing Address - Country:US
Mailing Address - Phone:817-480-4121
Mailing Address - Fax:
Practice Address - Street 1:2501 PARKVIEW DR
Practice Address - Street 2:SUITE 312
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-5824
Practice Address - Country:US
Practice Address - Phone:817-480-4121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-21
Last Update Date:2015-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69901101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor