Provider Demographics
NPI:1417937061
Name:BUTMAN-PERKINS, DEBRA ANNE (LPC-MH, NCC, RPT-S,)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ANNE
Last Name:BUTMAN-PERKINS
Suffix:
Gender:F
Credentials:LPC-MH, NCC, RPT-S,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-1619
Mailing Address - Country:US
Mailing Address - Phone:605-691-7630
Mailing Address - Fax:605-692-4906
Practice Address - Street 1:1431 7TH ST
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-1619
Practice Address - Country:US
Practice Address - Phone:605-691-7630
Practice Address - Fax:605-692-4906
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH #2051101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6575322Medicaid
SD4997875OtherBLUE CROSS/BLUE SHIELD #