Butler, Jackie M

Butler, Jackie M is an individual health care provider with primary practice located at 5209 W Wendover Ave , High Point NC 27265-9177. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Butler, Jackie M can be contacted via phone (336) 812-8645.

Contact Information

Primary practice address
5209 W Wendover Ave High Point NC 27265-9177
Phone: (336) 812-8645
Fax: (336) 812-8652
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 153 North Carolina

Profile Details

NPI number 1033237961
LBN Legal business name Butler, Jackie M
Credentials CCS
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033237961 NPPES
North Carolina MEDICAID 6110523

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