| Beth Barta Lcsw Cac 111 Llc | |
|
1750 N Lafayette St Denver CO 80218-1117 | |
| (209) 266-7667 | |
| (720) 386-9758 |
| Full Name | Beth Barta Lcsw Cac 111 Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1750 N Lafayette St, Denver, Colorado |
| Authorized Official Name and Position | Bethany Ann Barta (OWNER) |
| Authorized Official Contact | 7209266766 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beth Barta Lcsw Cac 111 Llc Po Box 181884 Denver CO 80218-8835 Ph: (303) 246-3219 | Beth Barta Lcsw Cac 111 Llc 1750 N Lafayette St Denver CO 80218-1117 Ph: (209) 266-7667 |
| NPI Number | 1427464932 |
|---|---|
| Provider Enumeration Date | 07/03/2014 |
| Last Update Date | 11/05/2024 |
| Certification Date | 11/05/2024 |
| Medicare PECOS PAC ID | 8628503208 |
|---|---|
| Medicare Enrollment ID | O20241119002692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427464932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 992831 (Colorado) | Primary |
| Provider Name | Erica L Kennedy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083114631 PECOS PAC ID: 3870857824 Enrollment ID: I20180430000239 |
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