Provider Demographics
NPI:1366732026
Name:BUTTERA, KARI ANN
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:ANN
Last Name:BUTTERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:ANN
Other - Last Name:WRATHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 MASSACHUSETTS AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3357
Mailing Address - Country:US
Mailing Address - Phone:703-336-9440
Mailing Address - Fax:
Practice Address - Street 1:625 MASSACHUSETTS AVE FL 2
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3357
Practice Address - Country:US
Practice Address - Phone:703-336-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0166951041C0700X
DCLC500788211041C0700X
VA09040081761041C0700X
IL1490251731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical