Provider Demographics
NPI:1043466097
Name:BUTLER, LYNNE MARIE (RN, LMHC)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:MARIE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:RN, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 NEWBURY ST
Mailing Address - Street 2:LOT 12
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-7464
Mailing Address - Country:US
Mailing Address - Phone:781-581-4442
Mailing Address - Fax:
Practice Address - Street 1:95 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1524
Practice Address - Country:US
Practice Address - Phone:781-581-4442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5131101YM0800X
MA176912163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163W00000XNursing Service ProvidersRegistered Nurse