Provider Demographics
NPI:1538934609
Name:BUTAUD ARMISTEAD, REBECCA MICHELE (LCSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MICHELE
Last Name:BUTAUD ARMISTEAD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:MICHELE
Other - Last Name:BUTAUD ARMISTEAD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:REBECCA BUTAUD, LCSW
Mailing Address - Street 1:306 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5929
Mailing Address - Country:US
Mailing Address - Phone:337-377-8906
Mailing Address - Fax:
Practice Address - Street 1:306 WILSON ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5929
Practice Address - Country:US
Practice Address - Phone:337-377-8906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA81191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical