Provider Demographics
NPI:1912330119
Name:BUTLER, SARA ELISABETH (LPC-S)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:ELISABETH
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4170 W MARTIN LUTHER KING JR BLVD STE 902
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-7702
Mailing Address - Country:US
Mailing Address - Phone:479-222-1155
Mailing Address - Fax:479-668-4822
Practice Address - Street 1:4170 W MARTIN LUTHER KING JR BLVD STE 902
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-7702
Practice Address - Country:US
Practice Address - Phone:479-222-1155
Practice Address - Fax:479-668-4822
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1604046101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health