Provider Demographics
NPI:1730923400
Name:BUTTON, ALYSSA (PHD)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:BUTTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 2ND ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-2604
Mailing Address - Country:US
Mailing Address - Phone:716-860-4561
Mailing Address - Fax:
Practice Address - Street 1:2305 N PARHAM RD STE 1
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-3156
Practice Address - Country:US
Practice Address - Phone:804-828-4758
Practice Address - Fax:804-527-4728
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008473103TC0700X
LA1676103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical