Provider Demographics
NPI:1114084050
Name:BUTTON, MICHELLE VALERIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:VALERIE
Last Name:BUTTON
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 1:348 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3800
Mailing Address - Country:US
Mailing Address - Phone:631-941-1200
Mailing Address - Fax:631-941-1201
Practice Address - Street 1:348 MAIN ST
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3800
Practice Address - Country:US
Practice Address - Phone:631-941-1200
Practice Address - Fax:631-941-1201
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071106-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical