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NPI Code Detail

MEDICARE: MRS. HEIDI ANN BUTLER MSW, LCSW, CSAC

MEDICARE: MRS. HEIDI ANN BUTLER MSW, LCSW, CSAC
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
1101YM0800XMental Health Counselor6868-123WI
2101YA0400XAddiction (Substance Use Disorder) Counselor12079-131WI
31041C0700XClinical Social Worker6868-123WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821136300
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HEIDI ANN BUTLER MSW, LCSW, CSAC
Provider Business Mailing Address
First Line : 825 WALTON DR
Second Line :
City : PLYMOUTH
State : WI
Zip : 53073-5022
Country : US
Telephone Number : 920-892-4322
Fax Number :
Provider Business Practice Location Address
First Line : 825 WALTON DR
Second Line :
City : PLYMOUTH
State : WI
Zip : 53073-5022
Country : US
Telephone Number : 920-496-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2007
Last Update Date : 03/02/2026

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