Provider Demographics
NPI:1306470356
Name:BARTLEY, AMY WINTERS (MS, LPC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:WINTERS
Last Name:BARTLEY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5906
Mailing Address - Country:US
Mailing Address - Phone:972-872-8494
Mailing Address - Fax:
Practice Address - Street 1:2400 LAKESIDE BLVD STE 620
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4341
Practice Address - Country:US
Practice Address - Phone:817-754-0784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-28
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79528101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health