Provider Demographics
NPI:1629738687
Name:BUTLER, COURTNEY KENNEDY (LCSW, MPH, CPHQ)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:KENNEDY
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LCSW, MPH, CPHQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 2ND AVE N UNIT 1501
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-3746
Mailing Address - Country:US
Mailing Address - Phone:203-214-1479
Mailing Address - Fax:
Practice Address - Street 1:2800 DUPREE RD SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3205
Practice Address - Country:US
Practice Address - Phone:203-214-1479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-17
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1128681041C0700X
NCC0158501041C0700X
MI68011158191041C0700X
TN93681041C0700X
CT95461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical