Provider Demographics
NPI:1174002026
Name:BUTTERY, VANESSA IRENE (LIMHP, LMHP)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:IRENE
Last Name:BUTTERY
Suffix:
Gender:F
Credentials:LIMHP, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12930 EAGLE CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68142-5189
Mailing Address - Country:US
Mailing Address - Phone:402-960-1272
Mailing Address - Fax:
Practice Address - Street 1:12930 EAGLE CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68142-5189
Practice Address - Country:US
Practice Address - Phone:402-960-1272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-11
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5398101YM0800X
NE2545101YP2500X
NEP1538101YA0400X
NE2259101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)