Provider Demographics
NPI:1053354407
Name:BUTLER-PARDI, RACHEL YVONNE (LSW)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:YVONNE
Last Name:BUTLER-PARDI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 ASHLAND ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5327
Mailing Address - Country:US
Mailing Address - Phone:724-853-8624
Mailing Address - Fax:
Practice Address - Street 1:35 W PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2323
Practice Address - Country:US
Practice Address - Phone:724-433-1285
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA122651104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA553094OtherVALUE BEHAVIORAL HEALTH