Provider Demographics
NPI:1396469177
Name:BUTLER, AMBER PAIGE (MED, NCC, LPC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:PAIGE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MED, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 DRIFTWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-7898
Mailing Address - Country:US
Mailing Address - Phone:540-222-0833
Mailing Address - Fax:
Practice Address - Street 1:428 MCLAWS CIR STE 202A
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5654
Practice Address - Country:US
Practice Address - Phone:757-808-5250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704011700101YP2500X
VAPROV-0657247101YS0200X
VA0701011847101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool