Provider Demographics
NPI:1225466469
Name:BUTLER, SONDRA ANN (MSN, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SONDRA
Middle Name:ANN
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 DANA AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45207-1327
Mailing Address - Country:US
Mailing Address - Phone:513-241-1811
Mailing Address - Fax:513-241-2112
Practice Address - Street 1:2135 DANA AVE STE 410
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45207-1327
Practice Address - Country:US
Practice Address - Phone:513-241-1811
Practice Address - Fax:513-241-2112
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN328025163W00000X, 363LP0808X
OHCOA.19043NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily