Lashannon Sherica Butler

Individual provider Active NPI Clinical Social Worker · Clinton, MS

NPI 1255808945 · NPPES record last updated Aug 27, 2024

Key facts

NPI
1255808945
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
C7706 (MS)
Practice address
104 Glen Auburn Dr
Clinton, MS 39056-6051
Phone
(601) 919-6214
NPI assigned
Oct 31, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
C7706MSMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C7706 MS Yes

Addresses

Primary practice location

104 Glen Auburn Dr
Clinton, MS 39056-6051

Mailing address

104 Glen Auburn Dr
Clinton, MS 39056-6051
Phone (601) 919-6214

Other practice location 1

3530 Manor Dr Ste 5
Vicksburg, MS 39180-5625
Phone (601) 738-5280

Other providers in Clinton, MS

All providers in Clinton, MS · Clinical Social Worker in Mississippi

Sources for this page

Verify at the official NPI Registry.