Provider Demographics
NPI:1396263810
Name:BUTLER, ALISHIA (MCP, LADC-MH)
Entity type:Individual
Prefix:
First Name:ALISHIA
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MCP, LADC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12978
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73157-2978
Mailing Address - Country:US
Mailing Address - Phone:405-858-1760
Mailing Address - Fax:
Practice Address - Street 1:116 N BROAD ST STE D
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-3363
Practice Address - Country:US
Practice Address - Phone:405-858-2719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OK1335101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health