MEDICARE: JAMES DAVID BUTTON LMSW

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	104100000X	Social Worker	088867	NY

General Provider Information

NPI Number	:	1396184768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES DAVID BUTTON LMSW

Provider Business Mailing Address
First Line	:	255 JUNCTION RD
Second Line	:
City	:	MALONE
State	:	NY
Zip	:	12953-4224
Country	:	US
Telephone Number	:	518-483-6256
Fax Number	:	518-483-1126

Provider Business Practice Location Address
First Line	:	255 JUNCTION RD
Second Line	:
City	:	MALONE
State	:	NY
Zip	:	12953-4224
Country	:	US
Telephone Number	:	518-483-6256
Fax Number	:	518-483-1126

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

Provider Enumeration Date	:	06/19/2013
Last Update Date	:	06/19/2013

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