Provider Demographics
NPI:1457587081
Name:BUTLER, MARLINDA LEE (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARLINDA
Middle Name:LEE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 EXECUTIVE WAY STE 125
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-0634
Mailing Address - Country:US
Mailing Address - Phone:530-623-7225
Mailing Address - Fax:
Practice Address - Street 1:930 EXECUTIVE WAY STE 125
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0634
Practice Address - Country:US
Practice Address - Phone:530-623-7225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW69635101Y00000X
101YM0800X
CA1027521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health