Provider Demographics
NPI:1114075231
Name:NIELSON, LINDA BUTTERFIELD (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:BUTTERFIELD
Last Name:NIELSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 THREE FOUNTAINS DR
Mailing Address - Street 2:UNIT 105
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5257
Mailing Address - Country:US
Mailing Address - Phone:801-467-4488
Mailing Address - Fax:801-463-3632
Practice Address - Street 1:2319 FOOTHILL DR
Practice Address - Street 2:SUITE 275
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-1489
Practice Address - Country:US
Practice Address - Phone:801-467-4488
Practice Address - Fax:801-463-3632
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12521435011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical