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NPI Code Detail

MEDICARE: MRS. JANELLE MARIE BUTLER LPC

MEDICARE: MRS. JANELLE MARIE 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
1101Y00000XCounselor8720SC

General Provider Information

NPI Number : 1760162697
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANELLE MARIE BUTLER LPC
Provider Business Mailing Address
First Line : 296 BIG GAME LOOP
Second Line :
City : COLUMBIA
State : SC
Zip : 29229-8426
Country : US
Telephone Number : 803-230-6175
Fax Number :
Provider Business Practice Location Address
First Line : 801 GERVAIS ST # 2B
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-3125
Country : US
Telephone Number : 803-888-6714
Fax Number : 833-233-1250
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2023
Last Update Date : 07/25/2023

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