MEDICARE: PHILIP M.P. BUTTENFIELD LCSW

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW015093	PA

General Provider Information

NPI Number	:	1083627574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP M.P. BUTTENFIELD LCSW

Provider Business Mailing Address
First Line	:	409 HASTINGS ST
Second Line	:	SECOND FLOOR
City	:	PITTSBURGH
State	:	PA
Zip	:	15206-4505
Country	:	US
Telephone Number	:	412-805-6811
Fax Number	:

Provider Business Practice Location Address
First Line	:	409 HASTINGS ST
Second Line	:	SECOND FLOOR
City	:	PITTSBURGH
State	:	PA
Zip	:	15206-4505
Country	:	US
Telephone Number	:	412-805-6811
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	07/08/2007

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