Provider Demographics
NPI:1548425648
Name:BUTTS, RAYMOND EUGENE (LPC)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:EUGENE
Last Name:BUTTS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 SHARY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-9166
Mailing Address - Country:US
Mailing Address - Phone:417-334-4203
Mailing Address - Fax:
Practice Address - Street 1:630 SHARY VIEW RD
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-9166
Practice Address - Country:US
Practice Address - Phone:417-334-4203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007014050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health