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NPI Code Detail

MEDICARE: MARY LOGAN BUTCHER

MEDICARE: MARY LOGAN BUTCHER
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
1101Y00000XCounselorOH

General Provider Information

NPI Number : 1912849217
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY LOGAN BUTCHER
Provider Business Mailing Address
First Line : 13377 SMITH RD
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-7810
Country : US
Telephone Number : 440-340-5558
Fax Number : 440-340-5575
Provider Business Practice Location Address
First Line : 13377 SMITH RD
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-7810
Country : US
Telephone Number : 440-340-5558
Fax Number : 440-340-5575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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Directions to “ MARY LOGAN BUTCHER ” Practice Location

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