Individual
MARY BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
601 CHILDRENS LN, 4TH FLOOR, SOCIAL WORK DEPT, NORFOLK, VA 23507-1910
(757) 668-7916
(757) 668-7950
Mailing address
1231 BRANDON AVE, NORFOLK, VA 23507-1111
(757) 622-4668
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0904000729
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
286268
ANTHEM
VA
01
—
O89020
SENTARA
VA
Enumeration date
07/18/2006
Last updated
07/09/2007
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