MEDICARE: COUNTY OF BUTTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1043371727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF BUTTE

Provider Business Mailing Address
First Line	:	3217 COHASSET RD
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95973-5404
Country	:	US
Telephone Number	:	530-891-2980
Fax Number	:	530-895-6548

Provider Business Practice Location Address
First Line	:	82 TABLE MOUNTAIN BLVD
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95965-3578
Country	:	US
Telephone Number	:	530-538-7705
Fax Number	:	530-538-2161

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SCOTT KENNELLY
Credential	:	LCSW
Telephone Number	:	530-891-2980

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	08/14/2023

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1255497756 — MS. CAROLINE MCCLEARY NP
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Directions to “COUNTY OF BUTTE ” Practice Location

Language	Start Address	Practice Location

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