Individual
MARK BARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
904 MAINSTREET STE 200, HOPKINS, MN 55343-7589
(866) 522-2472
Mailing address
904 MAINSTREET STE 200, HOPKINS, MN 55343-7589
(952) 562-4116
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2396
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1989
COMMERCIAL IN PROCESS
—
Enumeration date
05/07/2020
Last updated
05/07/2020
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