Healthcare Provider Details

I. General information

NPI: 1275864902
Provider Name (Legal Business Name): WILLIAM MACDUFF BUTLER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 01/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 S STATE ST STE 160
CLEARFIELD UT
84015-1061
US

IV. Provider business mailing address

189 S STATE ST STE 160
CLEARFIELD UT
84015-1061
US

V. Phone/Fax

Practice location:
  • Phone: 801-773-2044
  • Fax: 801-773-4826
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number263449-3501
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: