| Carla Butler, Lcsw, Pllc | |
|
317 Office Square Ln Ste B101 Virginia Beach VA 23462-3652 | |
| (757) 403-0119 | |
| Not Available |
| Full Name | Carla Butler, Lcsw, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 317 Office Square Ln Ste B101, Virginia Beach, Virginia |
| Authorized Official Name and Position | Carla Butler (PRESIDENT) |
| Authorized Official Contact | 7574030119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carla Butler, Lcsw, Pllc 317 Office Square Ln Ste B101 Virginia Beach VA 23462-3652 Ph: (757) 403-0119 | Carla Butler, Lcsw, Pllc 317 Office Square Ln Ste B101 Virginia Beach VA 23462-3652 Ph: (757) 403-0119 |
| NPI Number | 1578031191 |
|---|---|
| Provider Enumeration Date | 11/13/2018 |
| Last Update Date | 11/13/2018 |
| Medicare PECOS PAC ID | 8820338593 |
|---|---|
| Medicare Enrollment ID | O20190315000009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578031191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Carla Knoll Butler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982172789 PECOS PAC ID: 0648510313 Enrollment ID: I20190315000014 |
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