Individual
MR. LARRY BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
567 E 105TH ST, BROOKLYN, NY 11236-2213
(718) 307-3103
(718) 307-3020
Mailing address
567 E 105TH ST, BROOKLYN, NY 11236-2213
(718) 307-3103
(718) 307-3020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18053
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
261QM2800X
METHADONE CLINIC
NY
Enumeration date
12/16/2011
Last updated
12/16/2011
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