Provider Demographics
NPI:1336257591
Name:BUTLER, NANCY J (LCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
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 1:1261 HABERSHAM WAY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8588
Mailing Address - Country:US
Mailing Address - Phone:731-646-1131
Mailing Address - Fax:
Practice Address - Street 1:1601 NASHVILLE HWY
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-2948
Practice Address - Country:US
Practice Address - Phone:931-359-5802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW 38341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3105583OtherBCBS PROVIDER NUMBER
TN259380000Medicaid
TN3105583OtherBCBS PROVIDER NUMBER
TN39211251Medicare PIN