Provider Demographics
NPI:1538851126
Name:BUTLER, KIMBERLY JOY (MS)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JOY
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:JOY
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1118 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-1824
Mailing Address - Country:US
Mailing Address - Phone:253-241-1947
Mailing Address - Fax:
Practice Address - Street 1:2105 N FIFE ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-7611
Practice Address - Country:US
Practice Address - Phone:253-241-1947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health