Christa Kay Butcher, LCSW

Individual provider Active NPI Clinical Social Worker · Paintsville, KY

NPI 1972115699 · NPPES record last updated Apr 29, 2021

Key facts

NPI
1972115699
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
255100 (KY)
Practice address
851 S Mayo TRL
Paintsville, KY 41240-1215
Phone
(606) 372-2767
Fax
(606) 372-2768
NPI assigned
Aug 24, 2020
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)
Yes

State licenses

LicenseStateTypeSpecialty
8057TNMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP
1041C0700X 255100 KY Yes

Addresses

Primary practice location

851 S Mayo TRL
Paintsville, KY 41240-1215

Mailing address

851 S Mayo TRL
Paintsville, KY 41240-1215
Phone (606) 372-2767

Other practice location 1

9910 rt 581
River, KY 41254
Phone (606) 297-1037

Other identifiers

IdentifierTypeStateIssuer
7100697830MedicaidKY

Other providers in Paintsville, KY

All providers in Paintsville, KY · Clinical Social Worker in Kentucky

Sources for this page

Verify at the official NPI Registry.