Provider Demographics
NPI:1043043391
Name:BUTLER, ANNA (LCSW-A)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8045 ARCO CORPORATE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-2026
Mailing Address - Country:US
Mailing Address - Phone:919-372-3690
Mailing Address - Fax:
Practice Address - Street 1:8045 ARCO CORPORATE DR STE 120
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-2026
Practice Address - Country:US
Practice Address - Phone:919-372-3690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0205641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical