Provider Demographics
NPI:1063043016
Name:BUTEAU, CATESBY ELIZABETH (LMSW)
Entity Type:Individual
Prefix:
First Name:CATESBY
Middle Name:ELIZABETH
Last Name:BUTEAU
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CATESBY
Other - Middle Name:ELIZABETH
Other - Last Name:BERNSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 E 89TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1216
Mailing Address - Country:US
Mailing Address - Phone:929-242-8563
Mailing Address - Fax:
Practice Address - Street 1:40 E 89TH ST APT 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1216
Practice Address - Country:US
Practice Address - Phone:929-242-8563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104547-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker