Provider Demographics
NPI:1265085146
Name:BUTTERFIELD, ZACKARY (CMHC, MED, EDS, BCN)
Entity type:Individual
Prefix:MR
First Name:ZACKARY
Middle Name:
Last Name:BUTTERFIELD
Suffix:
Gender:M
Credentials:CMHC, MED, EDS, BCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1859 W VIEW POINT DR
Mailing Address - Street 2:
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84087-2533
Mailing Address - Country:US
Mailing Address - Phone:801-643-5619
Mailing Address - Fax:
Practice Address - Street 1:2317 N HILL FIELD RD STE 103
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-4782
Practice Address - Country:US
Practice Address - Phone:801-643-5619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10377393-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty