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NPI Code Detail

MEDICARE: MRS. HOLLY MICHELLE CARLYLE-BUTLER LCSWA, MSW, RYT

MEDICARE: MRS. HOLLY MICHELLE CARLYLE-BUTLER LCSWA, MSW, RYT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerP023529NC

General Provider Information

NPI Number : 1578418497
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HOLLY MICHELLE CARLYLE-BUTLER LCSWA, MSW, RYT
Provider Business Mailing Address
First Line : 9825 NC 41 HWY W
Second Line :
City : BLADENBORO
State : NC
Zip : 28320-8215
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 823 JEFFERSON ST
Second Line :
City : WHITEVILLE
State : NC
Zip : 28472-3703
Country : US
Telephone Number : 910-508-8904
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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