Provider Demographics
NPI:1013388792
Name:BUTLER, JASMINE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 JEFF RD NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-1238
Mailing Address - Country:US
Mailing Address - Phone:256-837-2127
Mailing Address - Fax:256-837-2174
Practice Address - Street 1:936 JEFF RD NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-1238
Practice Address - Country:US
Practice Address - Phone:256-837-2127
Practice Address - Fax:256-837-2174
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4123101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1013388792OtherNPI 1