Provider Demographics
NPI:1376557322
Name:SLOAN, BARTON S (LCSW)
Entity type:Individual
Prefix:
First Name:BARTON
Middle Name:S
Last Name:SLOAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 VISTA CIR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-1243
Mailing Address - Country:US
Mailing Address - Phone:907-250-9477
Mailing Address - Fax:360-205-3827
Practice Address - Street 1:1806 VISTA CIR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-1243
Practice Address - Country:US
Practice Address - Phone:907-250-9477
Practice Address - Fax:360-205-3827
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA605792901041C0700X
VA09040151711041C0700X
AK1971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK151287Medicare ID - Type UnspecifiedMEDICARE #