MEDICARE: MICHELLE LYNNE BUTMAN COLLINS LICSW

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
1	1041C0700X	Clinical Social Worker
2	1041C0700X	Clinical Social Worker	115426	MA

General Provider Information

NPI Number	:	1154538056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE LYNNE BUTMAN COLLINS LICSW

Provider Business Mailing Address
First Line	:	24 KENDRICK RD
Second Line	:
City	:	WAKEFIELD
State	:	MA
Zip	:	01880-4308
Country	:	US
Telephone Number	:	857-540-1021
Fax Number	:

Provider Business Practice Location Address
First Line	:	44B GROVE ST UNIT 8
Second Line	:
City	:	MELROSE
State	:	MA
Zip	:	02176-4696
Country	:	US
Telephone Number	:	781-226-1606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	05/31/2026

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