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General NPI Number Information
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NPI Number | 1134506777
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Entity Type | Individual
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Provider Name | CARY DARREN BUTLER MA, LPC, ALPS
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Gender | Male
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Dates
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Enumeration Date | 05/04/2015
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Last Update Date | 05/04/2015
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Provider Practice Location Address
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Address Line | 1102 MEMORIAL BLVD W
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City | HUNTINGTON
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State | WV
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Zip | 25701-4540
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Country | US
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Telephone | 304-523-9454
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Fax | 304-525-7038
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Provider Business Mailing Address
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Address Line | 1102 MEMORIAL BOULEVARD WEST
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City | HUNTINGTON
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State | WV
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Zip | 25701
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Country | US
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Telephone | 304-523-9454
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Fax | 304-525-7038
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1428
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License Number State | WV
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