Provider Demographics
NPI:1619558988
Name:BUTLER, DONNELL (LPC)
Entity Type:Individual
Prefix:
First Name:DONNELL
Middle Name:
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 1:8461 TURNPIKE DR STE 203
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-4379
Mailing Address - Country:US
Mailing Address - Phone:303-214-2106
Mailing Address - Fax:303-265-9247
Practice Address - Street 1:8461 TURNPIKE DR STE 203
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-4379
Practice Address - Country:US
Practice Address - Phone:303-214-2106
Practice Address - Fax:303-265-9247
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0016158OtherLICSENCE NUMBER