Provider Demographics
NPI:1447447321
Name:BARTLEY, MEGAN BAYLES (MAMFT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:BAYLES
Last Name:BARTLEY
Suffix:
Gender:F
Credentials:MAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 FALLEN TIMBER DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-1619
Mailing Address - Country:US
Mailing Address - Phone:512-507-1518
Mailing Address - Fax:
Practice Address - Street 1:10200 FOREST GREEN BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5165
Practice Address - Country:US
Practice Address - Phone:502-213-5940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0886106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist