Tatavia Butler, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

101952 Issued in CA

Practice address

7707 South Austin Rd
Stockton, CA 95215-8312

Phone

(818) 570-6752

Fax

(818) 570-6752

NPI assigned

Apr 1, 2013

Reactivated

Oct 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• 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

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD
• Focis Counseling Services, Inc.

  • Community/Behavioral Health Agency
  • Oklahoma City, OK
  • NPI 1760676928
  NPD (past)

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1629311394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3245",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945403245",
            "telephone_number": "405-431-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7707 SOUTH AUSTIN RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952158312",
            "telephone_number": "818-570-6752",
            "fax_number": "818-570-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "TATAVIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-01",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "deactivation_date": "2022-10-19",
        "reactivation_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "101952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annelisa Butcher, PPS
• Benjamin Mam Buth
• Wendy Buthenuth
• Brittany Butler
• Paris Butler
• Sukhchain Singh Buttar
• Butte Therapy Systems
• Butte Therapy Systems Stockton
• Butterfly Effects
• Butterfly Effects

• Clinical Social Worker in Stockton, CA
• Providers in Stockton, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.