Provider Demographics
NPI:1518001510
Name:BARTLING, DIANA K (MA, LCPC)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:K
Last Name:BARTLING
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 W JOLIET HWY
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-2111
Mailing Address - Country:US
Mailing Address - Phone:815-485-2609
Mailing Address - Fax:815-462-3866
Practice Address - Street 1:114 CHURCH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1856
Practice Address - Country:US
Practice Address - Phone:815-462-3866
Practice Address - Fax:815-462-3866
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional