Provider Demographics
NPI:1952548489
Name:BARTELS, WILLIAM MACK (PSYD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MACK
Last Name:BARTELS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 OTIS RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-7607
Mailing Address - Country:US
Mailing Address - Phone:914-805-3094
Mailing Address - Fax:888-894-4861
Practice Address - Street 1:144 ROUTE 17M
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:NY
Practice Address - Zip Code:10926-3329
Practice Address - Country:US
Practice Address - Phone:914-805-3094
Practice Address - Fax:888-894-4861
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016948-1103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent