Provider Demographics
NPI:1629469101
Name:BUTLER, LAUREN MIKALA (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MIKALA
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 1:4305 AFTONSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-8266
Mailing Address - Country:US
Mailing Address - Phone:910-231-5713
Mailing Address - Fax:
Practice Address - Street 1:4014 OLEANDER DR STE 101
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6811
Practice Address - Country:US
Practice Address - Phone:910-707-4160
Practice Address - Fax:910-401-1001
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0130771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical