Provider Demographics
NPI:1861615999
Name:BUTLER, GEORGE W (LMFT, LPC)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:W
Last Name:BUTLER
Suffix:
Gender:M
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 BUFFALO GAP RD
Mailing Address - Street 2:STE 3975
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-2723
Mailing Address - Country:US
Mailing Address - Phone:325-690-1995
Mailing Address - Fax:325-690-6030
Practice Address - Street 1:4400 BUFFALO GAP RD
Practice Address - Street 2:STE 3975
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-2723
Practice Address - Country:US
Practice Address - Phone:325-690-1995
Practice Address - Fax:325-690-6030
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1547101YP2500X
TX0894106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2628LCOtherBCBS