Provider Demographics
NPI:1700035805
Name:BUTLER, FRED F (CDMS)
Entity Type:Individual
Prefix:MR
First Name:FRED
Middle Name:F
Last Name:BUTLER
Suffix:
Gender:M
Credentials:CDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 6TH ST. SE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646
Mailing Address - Country:US
Mailing Address - Phone:330-316-7634
Mailing Address - Fax:300-837-3967
Practice Address - Street 1:48 6TH ST SE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-6874
Practice Address - Country:US
Practice Address - Phone:330-316-7634
Practice Address - Fax:300-837-3967
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker