Provider Demographics
NPI:1760428080
Name:BUTLER, DEBORAH L (MSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 ROCK ST
Mailing Address - Street 2:FRFSA
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3201
Mailing Address - Country:US
Mailing Address - Phone:508-235-3436
Mailing Address - Fax:
Practice Address - Street 1:2425 HIGHLAND AVE
Practice Address - Street 2:ST. VINCENT'S HOME
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-4508
Practice Address - Country:US
Practice Address - Phone:508-235-3436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW014091041C0700X
MA1100411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI62-28559OtherUNITED BEHAVIORAL HEALTH
RI29521-7OtherBLUE CROSS
RI412570OtherBLUE CHIP
RIDB56358Medicaid