| Doctor Name: | JACKIE M BUTLER |
| NPI Number: | 1033237961 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CCS |
| License Number: | 153 |
| Business Practice Address: | 5209 W Wendover Ave High Point, NC - 272659177 |
| Business Phone Number: | 3368128645 |
| Business Fax Number: | 3368128652 |
| Mailing Address: | 1404 Heatherbrook Dr, HIGH POINT |
| State: | NC |
| Postal Code: | 272659515 |
| Phone Number: | 3368800642 |
| Fax Number: | |
| NPI Enumeration Date: | 03/27/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 153 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |