Provider Demographics
NPI:1215571534
Name:BUTLER, SCOTT FRANCIS (PDD, LPC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:FRANCIS
Last Name:BUTLER
Suffix:
Gender:M
Credentials:PDD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1465
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-1465
Mailing Address - Country:US
Mailing Address - Phone:479-903-9106
Mailing Address - Fax:
Practice Address - Street 1:305 NW PALOMINO ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-6472
Practice Address - Country:US
Practice Address - Phone:479-903-9106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1902019101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health