Provider Demographics
NPI:1710677257
Name:WILLEY, CYNTHIA BUTLER (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:BUTLER
Last Name:WILLEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16070 WOODRING CT
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-2965
Mailing Address - Country:US
Mailing Address - Phone:248-345-2440
Mailing Address - Fax:
Practice Address - Street 1:16070 WOODRING CT
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-2965
Practice Address - Country:US
Practice Address - Phone:248-345-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010783821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical