Provider Demographics
NPI:1255065629
Name:BARTLEY, CALYSTA (LPCC)
Entity type:Individual
Prefix:
First Name:CALYSTA
Middle Name:
Last Name:BARTLEY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 TURNBERRY DR APT B
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-6842
Mailing Address - Country:US
Mailing Address - Phone:512-216-0770
Mailing Address - Fax:
Practice Address - Street 1:5858 N HIGH ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4183
Practice Address - Country:US
Practice Address - Phone:614-842-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1901254101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health