Provider Demographics
NPI:1396381620
Name:BUTLER, HEATHER LOUISE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LOUISE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 N WITCHDUCK RD STE 1B
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6556
Mailing Address - Country:US
Mailing Address - Phone:757-385-0914
Mailing Address - Fax:757-961-0184
Practice Address - Street 1:258 N WITCHDUCK RD STE 1B
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6556
Practice Address - Country:US
Practice Address - Phone:757-385-0914
Practice Address - Fax:757-961-0184
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008764101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional