MEDICARE: JOY ANN BUTCHER-WINFREE MA

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	103TC0700X	Clinical Psychologist	1089	WV

General Provider Information

NPI Number	:	1427139260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY ANN BUTCHER-WINFREE MA

Provider Business Mailing Address
First Line	:	176 MEDICAL CENTER DR
Second Line	:
City	:	RAINELLE
State	:	WV
Zip	:	25962-1064
Country	:	US
Telephone Number	:	304-438-6188
Fax Number	:	304-438-6819

Provider Business Practice Location Address
First Line	:	760 HORTON LN
Second Line	:
City	:	PRINCETON
State	:	WV
Zip	:	24739-6755
Country	:	US
Telephone Number	:	304-672-2098
Fax Number	:	304-384-7231

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	03/09/2021

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