Provider Demographics
NPI:1811268311
Name:BUTLER, CHARICE M (LIMHP)
Entity type:Individual
Prefix:
First Name:CHARICE
Middle Name:M
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 GALVIN RD S. STE A
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005
Mailing Address - Country:US
Mailing Address - Phone:402-850-7226
Mailing Address - Fax:402-625-0664
Practice Address - Street 1:919 GALVIN RD S. STE A
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005
Practice Address - Country:US
Practice Address - Phone:402-850-7226
Practice Address - Fax:402-625-0664
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-16
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9571101YM0800X
NE1380101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health