Provider Demographics
NPI:1396300976
Name:BARTLETT, DANIELLE KAY (MED, LPC-I)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:KAY
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:MED, LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 W 22ND ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-5104
Mailing Address - Country:US
Mailing Address - Phone:512-651-5598
Mailing Address - Fax:
Practice Address - Street 1:612 W 22ND ST UNIT B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-5104
Practice Address - Country:US
Practice Address - Phone:512-651-5598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78485101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health