Provider Demographics
NPI:1427464932
Name:BETH BARTA LCSW CAC 111 LLC
Entity type:Organization
Organization Name:BETH BARTA LCSW CAC 111 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BARTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-926-6766
Mailing Address - Street 1:PO BOX 181884
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-8835
Mailing Address - Country:US
Mailing Address - Phone:303-246-3219
Mailing Address - Fax:720-386-9758
Practice Address - Street 1:1750 N LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1117
Practice Address - Country:US
Practice Address - Phone:209-266-7667
Practice Address - Fax:720-386-9758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-03
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9928311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty