Provider Demographics
NPI:1811086200
Name:BUTLER-CRAYTON, DOROTHY CHRISTINE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:CHRISTINE
Last Name:BUTLER-CRAYTON
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 1:76 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:ROOSEVELT
Mailing Address - State:NY
Mailing Address - Zip Code:11575-1305
Mailing Address - Country:US
Mailing Address - Phone:917-731-6042
Mailing Address - Fax:
Practice Address - Street 1:76 HENRY ST
Practice Address - Street 2:
Practice Address - City:ROOSEVELT
Practice Address - State:NY
Practice Address - Zip Code:11575-1305
Practice Address - Country:US
Practice Address - Phone:917-731-6042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048277104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker