Provider Demographics
NPI:1578226957
Name:BUTLER, WILLIAM SR
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:BUTLER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 W 1ST NORTH ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-4548
Mailing Address - Country:US
Mailing Address - Phone:423-616-0213
Mailing Address - Fax:865-381-0521
Practice Address - Street 1:836 W 1ST NORTH ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-4548
Practice Address - Country:US
Practice Address - Phone:423-616-0213
Practice Address - Fax:865-381-0521
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101YM0800X, 175T00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No175T00000XOther Service ProvidersPeer Specialist