Provider Demographics
NPI:1053477919
Name:BUTTS, PATSY G (LPC, PHD)
Entity Type:Individual
Prefix:
First Name:PATSY
Middle Name:G
Last Name:BUTTS
Suffix:
Gender:F
Credentials:LPC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1893 WIDE RIVER DR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-4433
Mailing Address - Country:US
Mailing Address - Phone:435-656-9248
Mailing Address - Fax:435-656-9258
Practice Address - Street 1:1893 WIDE RIVER DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4433
Practice Address - Country:US
Practice Address - Phone:435-656-9248
Practice Address - Fax:435-656-9258
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT309518-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health