Provider Demographics
NPI:1205908712
Name:BUTLER, MARIAN R (LMHC)
Entity type:Individual
Prefix:
First Name:MARIAN
Middle Name:R
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 MCKINLEY TER
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6607
Mailing Address - Country:US
Mailing Address - Phone:413-443-3796
Mailing Address - Fax:
Practice Address - Street 1:25 MARSHALL ST
Practice Address - Street 2:BRIEN CENTER
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2451
Practice Address - Country:US
Practice Address - Phone:413-664-4541
Practice Address - Fax:413-662-3311
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3682101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA31735OtherHEALTH NEW ENGLAND