Provider Demographics
NPI:1235124447
Name:BUTLER, PATRICIA LYNN (LICSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 2ND NH TPKE
Mailing Address - Street 2:
Mailing Address - City:NEW BOSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03070-4405
Mailing Address - Country:US
Mailing Address - Phone:603-487-5537
Mailing Address - Fax:
Practice Address - Street 1:7 PROSPECT ST
Practice Address - Street 2:COMMUNITY COUNCIL OF NASHUA
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3921
Practice Address - Country:US
Practice Address - Phone:603-889-6147
Practice Address - Fax:603-598-7135
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH14Y000870NH01OtherBLUE CROSS
NHRE5723Medicare ID - Type Unspecified