Healthcare Provider Details

I. General information

NPI: 1093887911
Provider Name (Legal Business Name): VIRGINIA LEAH BUTLER MS LICENSED PROFESSI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 N SPRING ST
HARRISON AR
72601-2904
US

IV. Provider business mailing address

815 N SPRING ST STE 1
HARRISON AR
72601-2904
US

V. Phone/Fax

Practice location:
  • Phone: 870-204-5697
  • Fax: 870-204-5480
Mailing address:
  • Phone: 870-204-5697
  • Fax: 870-204-5480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP9903006
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: