Provider Demographics
NPI:1598836041
Name:BUTLER, JOY A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:A
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 1:214 HUDSON HILLS DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1346
Mailing Address - Country:US
Mailing Address - Phone:845-565-4040
Mailing Address - Fax:
Practice Address - Street 1:214 HUDSON HILLS DR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1346
Practice Address - Country:US
Practice Address - Phone:845-565-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0596131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN556G2Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER