Healthcare Provider Details
I. General information
NPI: 1205773207
Provider Name (Legal Business Name): BRANDI N BUTTRICK CDCAPRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1021 GEMINI PL
COLUMBUS OH
43240-6092
US
IV. Provider business mailing address
170 N 20TH ST
COLUMBUS OH
43203-1549
US
V. Phone/Fax
- Phone: 614-841-7708
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 195723 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: