Provider Demographics
NPI:1679899918
Name:BUTLER, LISA K (LPC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:K
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 1:406 5TH ST N STE 4
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:AL
Mailing Address - Zip Code:35121-1575
Mailing Address - Country:US
Mailing Address - Phone:205-353-9506
Mailing Address - Fax:
Practice Address - Street 1:406 5TH ST N STE 4
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121-1575
Practice Address - Country:US
Practice Address - Phone:205-353-9506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2570101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional