Doctor Name: | MRS. JACQUELINE DENISE BUTLER |
NPI Number: | 1386782993 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 0904006406 |
Business Practice Address: | 522 S Independence Blvd Ste 105 Virginia Beach, VA - 234521149 |
Business Phone Number: | 7574569205 |
Business Fax Number: | 7574569209 |
Mailing Address: | Po Box 62331, VIRGINIA BEACH |
State: | VA |
Postal Code: | 234662331 |
Phone Number: | 7574569205 |
Fax Number: | 7574569209 |
NPI Enumeration Date: | 02/03/2007 |
NPI Last Update Date: | 05/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 0904006406 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |