Provider Demographics
NPI:1295191203
Name:BUTLER, SHARIF (LPC)
Entity type:Individual
Prefix:
First Name:SHARIF
Middle Name:
Last Name:BUTLER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 AVA CT
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2843
Mailing Address - Country:US
Mailing Address - Phone:267-602-1175
Mailing Address - Fax:
Practice Address - Street 1:520 CARPENTER LN LBBY SUITE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-3453
Practice Address - Country:US
Practice Address - Phone:267-602-1175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health