Provider Demographics
NPI:1609187673
Name:BUTLER, LISA N (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:N
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:M
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:6535 N CHARLES ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-5826
Mailing Address - Country:US
Mailing Address - Phone:410-938-5252
Mailing Address - Fax:410-938-5250
Practice Address - Street 1:6535 N CHARLES ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-5826
Practice Address - Country:US
Practice Address - Phone:410-938-5252
Practice Address - Fax:410-938-5250
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3534101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional