Provider Demographics
NPI:1225217227
Name:BUTCHER, LESLIE A (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:A
Last Name:BUTCHER
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 1:1213 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-6725
Mailing Address - Country:US
Mailing Address - Phone:575-437-8181
Mailing Address - Fax:575-439-9701
Practice Address - Street 1:3892 BASSWOOD DR
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-8264
Practice Address - Country:US
Practice Address - Phone:575-430-0488
Practice Address - Fax:575-439-9701
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM006112101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health