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General NPI Number Information
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NPI Number | 1679889919
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Entity Type | Individual
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Provider Name | MARK ALAN BUTCHER LPC, LMHC
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Gender | Male
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2602 S 38TH ST UNIT 193
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City | TACOMA
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State | WA
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Zip | 98409-6665
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Country | US
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Telephone | 253-287-5367
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Fax |
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Provider Business Mailing Address
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Address Line | 2602 S. 38TH ST #193
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City | TACOMA
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State | WA
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Zip | 98409
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Country | US
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Telephone | 253-287-5367
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LH60697728
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License Number State | WA
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