Provider Demographics
NPI:1407524788
Name:BUTINA, NOBALEE ANN (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:NOBALEE
Middle Name:ANN
Last Name:BUTINA
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 BURNING OAKS DR
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-1958
Mailing Address - Country:US
Mailing Address - Phone:724-875-0919
Mailing Address - Fax:
Practice Address - Street 1:251 BURNING OAKS DR
Practice Address - Street 2:
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-1958
Practice Address - Country:US
Practice Address - Phone:724-875-0919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW123677104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker