Provider Demographics
NPI:1881233252
Name:BUTLER, STEPHANIE ALDRIDGE (LMHC, NCC, MCAP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ALDRIDGE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LMHC, NCC, MCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 CALHOUN AVE
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-1508
Mailing Address - Country:US
Mailing Address - Phone:850-296-3975
Mailing Address - Fax:
Practice Address - Street 1:457 CALHOUN AVE
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-1508
Practice Address - Country:US
Practice Address - Phone:850-296-3975
Practice Address - Fax:850-269-0194
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11273101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health