Provider Demographics
NPI:1861755308
Name:RIVERA BUTLER, KATHY (LMHC)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:
Last Name:RIVERA BUTLER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 W LITTLETON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2352
Mailing Address - Country:US
Mailing Address - Phone:303-730-1313
Mailing Address - Fax:720-458-6129
Practice Address - Street 1:609 W LITTLETON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2352
Practice Address - Country:US
Practice Address - Phone:303-730-1313
Practice Address - Fax:720-458-6129
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10339101YM0800X
CO13687101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health