Pamela Jean Butler, CSW, ACSW, MSSW
Individual provider Active NPI Social Worker · Fort Knox, KY
NPI 1174637987 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1174637987
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 2178 (KY)
- Practice address
- 289 Ireland Ave
VA Clinic
Fort Knox, KY 40121-5111 - Phone
- (502) 624-9372
- NPI assigned
- Aug 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2178 | KY | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 2178 | KY | Yes |
Addresses
Primary practice location
289 Ireland Ave
VA Clinic
Fort Knox, KY 40121-5111
Mailing address
105 Sharon CT
Elizabethtown, KY 42701-4608
Phone (270) 982-1076
Other providers in Fort Knox, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.