Provider Demographics
NPI:1518120542
Name:BUTLER, RITA MARIE (MC, LPC, LISAC)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:MARIE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MC, LPC, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 STEINWAY DR
Mailing Address - Street 2:
Mailing Address - City:WICKENBURG
Mailing Address - State:AZ
Mailing Address - Zip Code:85390-3184
Mailing Address - Country:US
Mailing Address - Phone:928-231-3193
Mailing Address - Fax:928-684-4442
Practice Address - Street 1:1325 STEINWAY DR
Practice Address - Street 2:
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-3184
Practice Address - Country:US
Practice Address - Phone:928-231-3193
Practice Address - Fax:928-684-4442
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-1689101YA0400X
AZLPC-10528101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)