Provider Demographics
NPI:1427648872
Name:BUTTELL, FREDERICK PATRICK (MSW, PHD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:PATRICK
Last Name:BUTTELL
Suffix:
Gender:M
Credentials:MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6308 MAGAZINE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5829
Mailing Address - Country:US
Mailing Address - Phone:504-376-5239
Mailing Address - Fax:
Practice Address - Street 1:1301 ANTONINE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3601
Practice Address - Country:US
Practice Address - Phone:504-376-5239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA75161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical