Provider Demographics
NPI:1063113850
Name:BUTLER-SMITH, VERA DENISE (CACII)
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:DENISE
Last Name:BUTLER-SMITH
Suffix:
Gender:F
Credentials:CACII
Other - Prefix:
Other - First Name:VERA
Other - Middle Name:DENISE
Other - Last Name:BUTLER-SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CACII
Mailing Address - Street 1:3917 KANSAS AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5711
Mailing Address - Country:US
Mailing Address - Phone:202-750-4783
Mailing Address - Fax:
Practice Address - Street 1:60 O ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-1259
Practice Address - Country:US
Practice Address - Phone:202-750-4783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCAC11LL71101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)