1144211467 NPI number — MS. KARI LYN BUTLER LCSW, MSW

Table of content: MS. KARI LYN BUTLER LCSW, MSW (NPI 1144211467)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144211467 NPI number — MS. KARI LYN BUTLER LCSW, MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUTLER
Provider First Name:
KARI
Provider Middle Name:
LYN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW, MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VAN BUSKIRK
Provider Other First Name:
KARI
Provider Other Middle Name:
LYN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW, MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144211467
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
409 TOSCHLOG ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47374
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
765-965-9796
Provider Business Mailing Address Fax Number:
765-965-4531

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
409 TOSCHLOG RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47374-5037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-965-9796
Provider Business Practice Location Address Fax Number:
765-965-4531
Provider Enumeration Date:
11/04/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  34004388A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)