Provider Demographics
NPI:1770165888
Name:BUTLER, BALIEGH JENE (LCSW)
Entity type:Individual
Prefix:
First Name:BALIEGH
Middle Name:JENE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2933 CROSS CREEK CT
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-8287
Mailing Address - Country:US
Mailing Address - Phone:814-762-5868
Mailing Address - Fax:
Practice Address - Street 1:109 GATEWAY AVE STE 206
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8471
Practice Address - Country:US
Practice Address - Phone:878-293-7723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0260751041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical