Colleen Butcher

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

B1-0001147 Issued in DE

Practice address

1600 Rockland Rd
Wilmington, DE 19803

Phone

(302) 651-4200

NPI assigned

Mar 16, 2015

Last updated

Jan 30, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbutcher386863@direct.wvuhsdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• West Virginia University Medical Corporation

  dba University Health Associates

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1275504508
  Medicare reassignment NPD
• West Virginia University Medical Corporation

  dba Crisis Support and Recovery Center

  • Community/Behavioral Health Agency
  • Martinsburg, WV
  • NPI 1174233530
  NPD

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1467845495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19803",
            "telephone_number": "302-651-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University Of New Mexico",
            "address_2": "MSC09 5030",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-5002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 Rockland Rd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198033648",
            "country_code": "US",
            "telephone_number": "302-651-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTCHER",
        "first_name": "COLLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "DE",
            "license": "B1-0001147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0640867",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193534800",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103268468",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dolores Maria Bush I, MSPT
• Russel Damien Buskirk, LCSW, LCDP
• Gordon A Bussard, M.D.
• Kalisandra G Bussey
• Ilian Bustos
• Stephanie Butler, DPT
• Julie A. Buzzelli, LMT
• BW Family Medical Center
• By the River Counseling and Wellness LLC
• Hal C. Byck, MD

• Clinical Child & Adolescent Psychologist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Clinical Child & Adolescent Psychologist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.