Provider Demographics
NPI:1881932580
Name:BUTCHER, STEPHANIE NICOLE (MS, LPC, PLPC)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:NICOLE
Last Name:BUTCHER
Suffix:
Gender:F
Credentials:MS, LPC, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12441 W 97TH TER
Mailing Address - Street 2:APT. 301
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-1501
Mailing Address - Country:US
Mailing Address - Phone:660-525-1004
Mailing Address - Fax:
Practice Address - Street 1:9601 NE BARRY RD
Practice Address - Street 2:SUITE 220
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-7633
Practice Address - Country:US
Practice Address - Phone:816-415-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2489101YP2500X
MO2012040526101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional