Provider Demographics
NPI:1730858739
Name:BARTH, AUSTIN LEE (LMHC, NCC)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:LEE
Last Name:BARTH
Suffix:
Gender:M
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:IA
Mailing Address - Zip Code:51638-0316
Mailing Address - Country:US
Mailing Address - Phone:712-246-8167
Mailing Address - Fax:
Practice Address - Street 1:610 NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:IA
Practice Address - Zip Code:51638-8033
Practice Address - Country:US
Practice Address - Phone:712-246-8167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA100413101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health