Provider Demographics
NPI:1134506777
Name:BUTLER, CARY DARREN (MA, LPC, ALPS)
Entity Type:Individual
Prefix:MR
First Name:CARY
Middle Name:DARREN
Last Name:BUTLER
Suffix:
Gender:M
Credentials:MA, LPC, ALPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 MEMORIAL BOULEVARD WEST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701
Mailing Address - Country:US
Mailing Address - Phone:304-523-9454
Mailing Address - Fax:304-525-7038
Practice Address - Street 1:1102 MEMORIAL BLVD W
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-4540
Practice Address - Country:US
Practice Address - Phone:304-523-9454
Practice Address - Fax:304-525-7038
Is Sole Proprietor?:No
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1428101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health