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NPI Code Detail

MEDICARE: MRS. LINDA ANN BUTLER-MOORE LPC

MEDICARE: MRS. LINDA ANN BUTLER-MOORE 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
1101YP2500XProfessional Counselor2275LA

General Provider Information

NPI Number : 1629373584
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDA ANN BUTLER-MOORE LPC
Provider Business Mailing Address
First Line : 1000 CHINABERRY DR STE 900
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71111-2455
Country : US
Telephone Number : 318-742-3408
Fax Number : 318-841-1210
Provider Business Practice Location Address
First Line : 1301 YOUREE DR
Second Line :
City : SHREVEPORT
State : LA
Zip : 71101-5117
Country : US
Telephone Number : 318-675-0804
Fax Number : 318-425-9030
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2011
Last Update Date : 09/30/2019

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