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General NPI Number Information
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NPI Number | 1740597152
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Entity Type | Individual
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Provider Name | NICOLE BUTLER LMSW, LCDC-I,ASOTP,
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Gender | Female
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Dates
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Enumeration Date | 09/07/2010
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 600 W PARK ROW DR STE A
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City | ARLINGTON
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State | TX
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Zip | 76010-2559
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Country | US
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Telephone | 901-213-7011
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Fax |
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Provider Business Mailing Address
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Address Line | 600 W PARK ROW DR STE A
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City | ARLINGTON
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State | TX
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Zip | 76010-2559
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Country | US
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Telephone | 901-213-7011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 220041788
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 68081
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License Number State | TX
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