Provider Demographics
NPI:1932934148
Name:BARTUSEK, KILEY
Entity type:Individual
Prefix:
First Name:KILEY
Middle Name:
Last Name:BARTUSEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 S EASTLAND DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-4130
Mailing Address - Country:US
Mailing Address - Phone:570-706-6052
Mailing Address - Fax:
Practice Address - Street 1:2727 OLD PHILADELPHIA PIKE STE 2A
Practice Address - Street 2:
Practice Address - City:BIRD IN HAND
Practice Address - State:PA
Practice Address - Zip Code:17505-9707
Practice Address - Country:US
Practice Address - Phone:717-594-9633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health