Provider Demographics
NPI:1548356165
Name:BUTLER, CYNTHIA LEE (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LEE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 HOMEWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:DAVIDSONVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21035
Mailing Address - Country:US
Mailing Address - Phone:301-261-4355
Mailing Address - Fax:
Practice Address - Street 1:2191 DEFENSE HIGHWAY
Practice Address - Street 2:SUITE 308
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114
Practice Address - Country:US
Practice Address - Phone:410-956-3454
Practice Address - Fax:410-721-3588
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD062291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD550QMedicare ID - Type Unspecified