Healthcare Provider Details

I. General information

NPI: 1225466469
Provider Name (Legal Business Name): SONDRA ANN BUTLER MSN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2013
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 MADISON RD STE 304
CINCINNATI OH
45209-2271
US

IV. Provider business mailing address

2727 MADISON RD STE 304
CINCINNATI OH
45209-2271
US

V. Phone/Fax

Practice location:
  • Phone: 513-533-6463
  • Fax: 513-533-6462
Mailing address:
  • Phone: 513-533-6463
  • Fax: 513-533-6462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN328025
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.19043NP
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN328025
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: