Bartlett, Justin

Bartlett, Justin is an sole proprietor health care provider with primary practice located at 631 S 1St St , Dekalb IL 60115-4117. He recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as his primary health care specialty. Bartlett, Justin can be contacted via phone (815) 756-8501.

Contact Information

Primary practice address
631 S 1St St Dekalb IL 60115-4117
Phone: (815) 756-8501
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1881136398
LBN Legal business name Bartlett, Justin
Credentials Bachelor of Arts (BA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 15th, 2016
Last updated Nov 15th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881136398 NPPES
Illinois MEDICAID 4745791809001

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