Individual provider Active NPI

June Butera Pouliot, LCSW

  • Clinical Social Worker
  • Pensacola, FL
National Provider Identifier
1609109826
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 8265 Issued in FL
Practice address
3300 N Pace Blvd
Suite 306
Pensacola, FL 32505
Phone
(850) 390-1800
Fax
(850) 912-4193
NPI assigned
Sep 8, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW 8265 FL Primary

Addresses

Primary practice location

3300 N Pace Blvd
Suite 306
Pensacola, FL 32505

Mailing address

3300 N Pace Blvd
Suite 306
Pensacola, FL 32505-5148
Phone (850) 390-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 8265FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Therapy Services, Inc CurrentSince Jul 17, 2021 Accepting new patients

Locations

6425 Pensacola Blvd
#13
Pensacola, FL 32505
Phone (850) 471-0017

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1609109826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N PACE BLVD",
            "address_2": "SUITE 306",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325055148",
            "telephone_number": "850-390-1800",
            "fax_number": "850-912-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 N PACE BLVD",
            "address_2": "SUITE 306",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32505",
            "telephone_number": "850-390-1800",
            "fax_number": "850-912-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULIOT",
        "first_name": "JUNE",
        "middle_name": "BUTERA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-08",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 8265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.