Healthcare Provider Details

I. General information

NPI: 1679942486
Provider Name (Legal Business Name): CHRISSY BUTLER MHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2015
Last Update Date: 12/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S BROAD ST SUITE 7
NEW ORLEANS LA
70119-6447
US

IV. Provider business mailing address

200 S BROAD ST SUITE 7
NEW ORLEANS LA
70119-6447
US

V. Phone/Fax

Practice location:
  • Phone: 504-309-9991
  • Fax:
Mailing address:
  • Phone: 504-309-9991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: