Provider Demographics
NPI:1144554114
Name:BUTTERFIELD, ELLEN M (LMFT)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:M
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4046 SHADYGLADE AVE
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-1635
Mailing Address - Country:US
Mailing Address - Phone:818-458-3344
Mailing Address - Fax:
Practice Address - Street 1:4046 SHADYGLADE AVE
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-1635
Practice Address - Country:US
Practice Address - Phone:818-458-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC33531106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist