Provider Demographics
NPI:1114186863
Name:BUTLER, DODI ANN (LPC)
Entity Type:Individual
Prefix:
First Name:DODI
Middle Name:ANN
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 DORIS RD
Mailing Address - Street 2:
Mailing Address - City:SCOTT TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18447-7752
Mailing Address - Country:US
Mailing Address - Phone:570-878-5201
Mailing Address - Fax:
Practice Address - Street 1:1434 MT COBB RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18436-4504
Practice Address - Country:US
Practice Address - Phone:570-878-5201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-07
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004859101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional