Provider Demographics
NPI:1801260781
Name:BUTLER, KIRA (LAMFT)
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:KIRA
Other - Middle Name:
Other - Last Name:ROERIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAMFT
Mailing Address - Street 1:6410 S KENNETH PL UNIT D
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3875
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3048 E BASELINE RD STE 107
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-7287
Practice Address - Country:US
Practice Address - Phone:559-949-7788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAMFT-10455106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist