Healthcare Provider Details

I. General information

NPI: 1982566030
Provider Name (Legal Business Name): PAUL DAVID BUTLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MILLHOLLAND DR UNIT F
FISHKILL NY
12524-1549
US

IV. Provider business mailing address

10 MILLHOLLAND DR UNIT F
FISHKILL NY
12524-1549
US

V. Phone/Fax

Practice location:
  • Phone: 914-246-4100
  • Fax: 888-301-8044
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number18-P130729-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: