MEDICARE: SARAH ESCOBAR-BUTEAU LCMHC, MLADC

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	101YM0800X	Mental Health Counselor	2487	NH
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	1235	NH

General Provider Information

NPI Number	:	1225620248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ESCOBAR-BUTEAU LCMHC, MLADC

Provider Business Mailing Address
First Line	:	25 COUNTRY CLUB RD UNIT 705
Second Line	:
City	:	GILFORD
State	:	NH
Zip	:	03249-6977
Country	:	US
Telephone Number	:	603-524-8005
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 COUNTRY CLUB RD UNIT 705
Second Line	:
City	:	GILFORD
State	:	NH
Zip	:	03249-6977
Country	:	US
Telephone Number	:	603-524-8005
Fax Number	:

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

Provider Enumeration Date	:	02/10/2021
Last Update Date	:	08/05/2022

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