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NPI Code Detail

MEDICARE: MISS ANDREA CALVERT BUTLER

MEDICARE: MISS ANDREA CALVERT 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 Counselor
2106H00000XMarriage & Family TherapistMT2715FL

General Provider Information

NPI Number : 1205029899
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ANDREA CALVERT BUTLER
Provider Business Mailing Address
First Line : 136 JULIA ST UNIT 100
Second Line :
City : NEW SMYRNA BEACH
State : FL
Zip : 32168-7713
Country : US
Telephone Number : 386-423-9161
Fax Number :
Provider Business Practice Location Address
First Line : 136 JULIA ST UNIT 100
Second Line :
City : NEW SMYRNA BEACH
State : FL
Zip : 32168-7713
Country : US
Telephone Number : 386-423-9161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2007
Last Update Date : 08/23/2022

Similar Medicare Providers

1801858329 — MR. SHANE C PORTER LMHC
Practice Location Address:
136 JULIA ST
NEW SMYRNA BEACH, FL
32168-7713
Practice Phone: 386-423-9161
Practice Fax: 386-423-3094
1811959331 — DR. TIMOTHY S SHAW PHD
Practice Location Address:
136 JULIA ST UNIT 100
NEW SMYRNA BEACH, FL
32168-7713
Practice Phone: 386-423-9161
Practice Fax: 386-423-3094
1790858959 — DR. JERRY L. OESTMANN PH.D.
Practice Location Address:
136 JULIA ST UNIT 100
NEW SMYRNA BEACH, FL
32168-7713
Practice Phone: 386-423-9162
Practice Fax: 386-423-3094
1558408344 — MRS. POTOULA DIAZ MS, LMHC
Practice Location Address:
136 JULIA ST
NEW SMYRNA BEACH, FL
32168-7713
Practice Phone: 386-423-9161
Practice Fax: 386-423-3094
1952562274 — THOMAS R. SAUNDERS PH.D.
Practice Location Address:
136 JULIA ST UNIT 100
NEW SMYRNA BEACH, FL
32168-7713
Practice Phone: 386-423-9161
Practice Fax: 386-423-3094
1376794610 — SARAH KATHERINE KUYKENDALL LCSW
Practice Location Address:
136 JULIA ST UNIT 100
NEW SMYRNA BEACH, FL
32168-7713
Practice Phone: 386-423-9161
Practice Fax: 386-423-3094

Directions to “ MISS ANDREA CALVERT BUTLER ” Practice Location

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