Provider Demographics
NPI:1699811208
Name:BUTLER, LYNANN H (LPC, CACIII)
Entity Type:Individual
Prefix:MS
First Name:LYNANN
Middle Name:H
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LPC, CACIII
Other - Prefix:
Other - First Name:PROFESSIONAL
Other - Middle Name:COUNSELING
Other - Last Name:SERVICES, INC.
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4155 E JEWELL AVE STE 308
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4507
Mailing Address - Country:US
Mailing Address - Phone:303-691-0225
Mailing Address - Fax:303-691-0224
Practice Address - Street 1:4155 E JEWELL AVE STE 308
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4507
Practice Address - Country:US
Practice Address - Phone:303-691-0225
Practice Address - Fax:303-691-0224
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4701101YA0400X
CO2640101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO75-3040083OtherEIN #