Provider Demographics
NPI:1245295070
Name:BUTLER, VINNIE M (LCSW)
Entity type:Individual
Prefix:
First Name:VINNIE
Middle Name:M
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 1:435 E MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1457
Mailing Address - Country:US
Mailing Address - Phone:317-743-8202
Mailing Address - Fax:317-743-8276
Practice Address - Street 1:435 E MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1457
Practice Address - Country:US
Practice Address - Phone:317-743-8202
Practice Address - Fax:317-743-8276
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0026980104100000X
IN34007879A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker