Provider Demographics
NPI:1982638847
Name:BUTTERFIELD, JILL T (MS ATRL-BC)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:T
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:MS ATRL-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 CHIPPEWA DR
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-2577
Mailing Address - Country:US
Mailing Address - Phone:262-695-8857
Mailing Address - Fax:262-695-8879
Practice Address - Street 1:161 W WISCONSIN AVE STE 2B
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-3468
Practice Address - Country:US
Practice Address - Phone:262-695-8857
Practice Address - Fax:262-695-8879
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI68-036101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40969200Medicaid