Provider Demographics
NPI:1144733841
Name:BUTTS, JAMES (LMSW-CC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:BUTTS
Suffix:
Gender:M
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 HODGDON RD
Mailing Address - Street 2:
Mailing Address - City:LEVANT
Mailing Address - State:ME
Mailing Address - Zip Code:04456-4327
Mailing Address - Country:US
Mailing Address - Phone:207-735-4904
Mailing Address - Fax:
Practice Address - Street 1:615 ODLIN RD STE 3
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6737
Practice Address - Country:US
Practice Address - Phone:207-947-3391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC170081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical