Provider Demographics
NPI:1336116623
Name:BUTZ, LYNN KATHRYN (MSW, LMSW, ACSW)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:KATHRYN
Last Name:BUTZ
Suffix:
Gender:F
Credentials:MSW, LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5317 SEYMOUR RD
Mailing Address - Street 2:
Mailing Address - City:SWARTZ CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:48473-1031
Mailing Address - Country:US
Mailing Address - Phone:810-635-3748
Mailing Address - Fax:810-635-3748
Practice Address - Street 1:3600 S DORT HWY
Practice Address - Street 2:SUITE 44
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2093
Practice Address - Country:US
Practice Address - Phone:810-744-3300
Practice Address - Fax:810-744-1090
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-05
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010468551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B56322013Medicare PIN