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Individual

JODY L BUTLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
307 HIGH ST, MARYVILLE, TN 37804-5847
(865) 386-4642
(865) 379-2869
Mailing address
307 HIGH ST, MARYVILLE, TN 37804-5847
(865) 386-4642
(865) 379-2869

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LDC0000000268
TN
1041C0700X
Clinical Social Worker
Primary
LSW0000004599
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LDC0000000268
STATE LICENSE
TN
01
LSW0000004599
STATE LICENSE
TN
Enumeration date
03/15/2006
Last updated
10/23/2009
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