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1356755581

NPI Code Detail

MEDICARE: RYAN BUTLER

MEDICARE: RYAN 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
1	1041C0700X	Clinical Social Worker	5868004-3501	UT
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1356755581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN BUTLER

Provider Business Mailing Address
First Line	:	1600 WEEOT WAY
Second Line	:
City	:	ARCATA
State	:	CA
Zip	:	95521-4734
Country	:	US
Telephone Number	:	707-825-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1675 NORTHCREST DR
Second Line	:
City	:	CRESCENT CITY
State	:	CA
Zip	:	95531-8928
Country	:	US
Telephone Number	:	707-464-2750
Fax Number	:

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

Provider Enumeration Date	:	06/16/2014
Last Update Date	:	04/18/2025

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Directions to “ RYAN BUTLER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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