MEDICARE: LAMONICA BUTLER LPC

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	101YP2500X	Professional Counselor	5946	LA

General Provider Information

NPI Number	:	1427408194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAMONICA BUTLER LPC

Provider Business Mailing Address
First Line	:	4327 OAKLAND RD
Second Line	:
City	:	ERWINVILLE
State	:	LA
Zip	:	70729-3413
Country	:	US
Telephone Number	:	225-341-0077
Fax Number	:

Provider Business Practice Location Address
First Line	:	4327 OAKLAND ROAD
Second Line	:
City	:	ERWINVILLE
State	:	LA
Zip	:	70729
Country	:	US
Telephone Number	:	225-341-0077
Fax Number	:

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

Provider Enumeration Date	:	06/14/2016
Last Update Date	:	06/14/2016

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