Provider Demographics
NPI:1356645766
Name:BUTLER, KATHIE LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHIE
Middle Name:LYNN
Last Name:BUTLER
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 1:111 LONGWOOD DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4522
Mailing Address - Country:US
Mailing Address - Phone:256-534-8161
Mailing Address - Fax:256-534-7254
Practice Address - Street 1:111 LONGWOOD DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4522
Practice Address - Country:US
Practice Address - Phone:256-534-8161
Practice Address - Fax:256-534-7254
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1467C104100000X
ALPIP-0519-1467C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1467COtherSTATE OF ALABAMA BOARD OF SOCIAL WORK EXAMINERS
ALPIP-0519-1467COtherSTATE OF ALABAMA BOARD OF SOCIAL WORK EXAMINERS