Provider Demographics
NPI:1205214269
Name:BUTLER, JULIE ANN (LMHC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4908 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-1901
Mailing Address - Country:US
Mailing Address - Phone:515-280-3860
Mailing Address - Fax:515-883-2683
Practice Address - Street 1:4908 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-1901
Practice Address - Country:US
Practice Address - Phone:515-280-3860
Practice Address - Fax:515-883-2683
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8867560-6009101YM0800X
AZLAC14470101YM0800X
CO12366101YP2500X
IA081447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional