Provider Demographics
NPI:1437647062
Name:BUTLER, PAKIZA MAHMUD (LPC)
Entity Type:Individual
Prefix:
First Name:PAKIZA
Middle Name:MAHMUD
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 1:1518 N HEARTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-1355
Mailing Address - Country:US
Mailing Address - Phone:832-368-8971
Mailing Address - Fax:
Practice Address - Street 1:1518 N HEARTHSIDE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-1355
Practice Address - Country:US
Practice Address - Phone:832-368-8971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74686101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX343525OtherTEXAS BOARD OF EXAMINERS OF PROFESSIONAL COUNSELOR