Provider Demographics
NPI:1144765934
Name:BUTRUM, LEEANN ELIZABETH (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:LEEANN
Middle Name:ELIZABETH
Last Name:BUTRUM
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:LEEANN
Other - Middle Name:ELIZABETH
Other - Last Name:LASHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1321 MURFREESBORO PIKE STE 702
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2679
Mailing Address - Country:US
Mailing Address - Phone:844-359-7629
Mailing Address - Fax:615-577-5654
Practice Address - Street 1:724 BARRETT BLVD STE A
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-4931
Practice Address - Country:US
Practice Address - Phone:707-024-6412
Practice Address - Fax:615-577-5654
Is Sole Proprietor?:No
Enumeration Date:2017-01-03
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-16-23928OtherBCBA CERTIFICATE