Healthcare Provider Details

I. General information

NPI: 1962864520
Provider Name (Legal Business Name): BUTLER COUNSELING & CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 03/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S THIRD ST
MEBANE NC
27302-2617
US

IV. Provider business mailing address

1003 STUART DR
MEBANE NC
27302-7111
US

V. Phone/Fax

Practice location:
  • Phone: 336-269-0818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number99NCFBPPC
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12018
License Number StateNC

VIII. Authorized Official

Name: DR. JUDY BUTLER
Title or Position: OWNER
Credential: PSYD
Phone: 336-269-0818