Butucha Wellness LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BUTUCHA WELLNESS LLC

Practice address

1362 Skipping Stone CT
Dacula, GA 30019-4006

Phone

(617) 960-6852

Fax

(877) 760-0480

NPI assigned

Apr 24, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Cuna, LICSW

Title

Ceo and President

Phone

(617) 960-6852

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1093402612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1362 SKIPPING STONE CT",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300194006",
            "telephone_number": "617-960-6852",
            "fax_number": "877-760-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1362 SKIPPING STONE CT",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300194006",
            "telephone_number": "617-960-6852",
            "fax_number": "877-760-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUTUCHA WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "CUNA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO AND PRESIDENT",
        "authorized_official_telephone_number": "617-960-6852",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14662512",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Bulluck, PT, DPT
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• Amy Burke, LMT
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• Yentl Butler, NP
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• Charlie Campbell

• Clinical Social Worker in Dacula, GA
• Providers in Dacula, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.