Provider Demographics
NPI:1568663888
Name:BUTLER, DEBRA S (MSLMFT)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:S
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MSLMFT
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:S
Other - Last Name:DUNCAN BUTLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS,LMFT
Mailing Address - Street 1:164 ROBLES WAY # 230
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-8039
Mailing Address - Country:US
Mailing Address - Phone:888-288-0620
Mailing Address - Fax:
Practice Address - Street 1:3150 HILLTOP MALL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806
Practice Address - Country:US
Practice Address - Phone:888-288-0620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51217106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist