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NPI Code Detail

MEDICARE: JESSIE LYNNE BUTLER

MEDICARE: JESSIE LYNNE BUTLER
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
1101YM0800XMental Health Counselor17059NC
2101YA0400XAddiction (Substance Use Disorder) CounselorLCAS-27765NC

General Provider Information

NPI Number : 1043888209
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSIE LYNNE BUTLER
Provider Business Mailing Address
First Line : 5 RAVENSCROFT DR STE 102
Second Line :
City : ASHEVILLE
State : NC
Zip : 28801-3683
Country : US
Telephone Number : 828-827-7239
Fax Number :
Provider Business Practice Location Address
First Line : 5 RAVENSCROFT DR STE 102
Second Line :
City : ASHEVILLE
State : NC
Zip : 28801-3683
Country : US
Telephone Number : 828-827-7239
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2021
Last Update Date : 10/08/2025

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Directions to “ JESSIE LYNNE BUTLER ” Practice Location

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