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General NPI Number Information
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NPI Number | 1578031191
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Entity Type | Organization
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Legal Business Name | CARLA BUTLER, LCSW, PLLC
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 11/13/2018
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Provider Practice Location Address
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Address Line | 317 OFFICE SQUARE LN STE B101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3652
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Country | US
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Telephone | 757-403-0119
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Fax |
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Provider Business Mailing Address
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Address Line | 317 OFFICE SQUARE LN STE B101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3652
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Country | US
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Telephone | 757-403-0119
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARLA BUTLER
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Credential | LCSW
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Telephone | 757-403-0119
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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 |
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License Number State |
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