Provider Demographics
NPI:1124820063
Name:BUTLER, HEATHER R (LMSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
Last Name:BUTLER
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:CORRYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37721-5118
Mailing Address - Country:US
Mailing Address - Phone:757-350-0972
Mailing Address - Fax:
Practice Address - Street 1:3606 W ANDREW JOHNSON HWY STE 19&20
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3603
Practice Address - Country:US
Practice Address - Phone:865-378-6929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15791104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker