Individual provider · NPI-1

Kenneth Michael Butler, SAC-IT, NREMT

Counselor, Addiction (Substance Use Disorder) · Milwaukee, WI

NPI number1023774114
StatusActive
Last updated in NPPESNov 12, 2021

Details

NPI
1023774114
Entity type
Individual (NPI-1)
Name
Mr. Kenneth Michael Butler
Credential
SAC-IT, NREMT
Sex
Male
Sole proprietor
Yes
Enumeration date
Nov 12, 2021
Certification date
Nov 12, 2021
Last updated
Nov 12, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YA0400X Counselor, Addiction (Substance Use Disorder)19378-130WIYes
146N00000X Emergency Medical Technician, BasicR1032909WI

Practice location

1681 N Prospect Ave
Milwaukee, WI 53202-6720

Phone 414-273-8484

Mailing address

1681 N Prospect Ave
Milwaukee, WI 53202-6720

Phone 414-273-8484

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