Provider Demographics
NPI:1619653755
Name:BUTCHER, LAUREN (LCSW-S)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:BUTCHER
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 W HOLIDAY
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-2151
Mailing Address - Country:US
Mailing Address - Phone:214-233-4434
Mailing Address - Fax:
Practice Address - Street 1:1101 RIDGE RD STE 133
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-4250
Practice Address - Country:US
Practice Address - Phone:214-233-4434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103767101YM0800X, 1041C0700X
FLTPSW49781041C0700X
VA09040178501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty