Healthcare Provider Details

I. General information

NPI: 1831497155
Provider Name (Legal Business Name): KAREN BUTTACAVOLI LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 OVERLOOK AVE
PEEKSKILL NY
10566-3004
US

IV. Provider business mailing address

150 OVERLOOK AVE
PEEKSKILL NY
10566-3004
US

V. Phone/Fax

Practice location:
  • Phone: 914-737-4220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number04475
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: