Provider Demographics
NPI:1649712522
Name:BUTLER, KRISTIN (LMHC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:CECIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3505 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-3718
Mailing Address - Country:US
Mailing Address - Phone:317-920-5900
Mailing Address - Fax:317-920-5911
Practice Address - Street 1:435 E MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1384
Practice Address - Country:US
Practice Address - Phone:317-788-4451
Practice Address - Fax:317-788-4465
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002945A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health