Provider Demographics
NPI:1164819009
Name:JILL T BUTTERFIELD MS, ATRL-BC LLC
Entity Type:Organization
Organization Name:JILL T BUTTERFIELD MS, ATRL-BC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:T
Authorized Official - Last Name:BUTTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, ATRL-BC
Authorized Official - Phone:262-224-1422
Mailing Address - Street 1:19275 W CAPITOL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-2742
Mailing Address - Country:US
Mailing Address - Phone:262-224-1422
Mailing Address - Fax:
Practice Address - Street 1:19275 W CAPITOL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-2742
Practice Address - Country:US
Practice Address - Phone:262-224-1422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI68036101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40969200Medicaid