Provider Demographics
NPI:1447951843
Name:BUTTERFIELD, SUSAN (LCSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62693-0042
Mailing Address - Country:US
Mailing Address - Phone:217-416-6494
Mailing Address - Fax:
Practice Address - Street 1:212 E HARPOLE ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62693-9714
Practice Address - Country:US
Practice Address - Phone:217-416-6494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490235811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical