Ellis Ray Butler II, LCAS-A

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCAS20060 Issued in NC

Practice address

536 Signal Hill Drive Ext
Statesville, NC 28625-4391

Phone

(704) 872-0234

NPI assigned

Aug 18, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ellis Ray Butler II Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503014400000",
    "number": "1124544457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 MONTGROVE PL NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280276554",
            "telephone_number": "980-319-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 SIGNAL HILL DRIVE EXT",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254391",
            "telephone_number": "704-872-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "ELLIS",
        "middle_name": "RAY",
        "name_suffix": "II",
        "credential": "LCAS-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-18",
        "last_updated": "2017-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS20060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLIS",
            "last_name": "BUTLER",
            "middle_name": "RAY",
            "suffix": "II",
            "credential": "PHD, LCAS-A",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Chelsea Jeannette Burns, MA, CCC-SLP
• Rhonda Joann Burrell III, RN
• Butlak Anesthesia Solutions, PA
• David Jonathan Butlak, CRNA
• David Richard Butler, RPH
• Ronald Butler, R.N.
• Kelsey Butz, AU.D
• C. Lee Bass, III, DDS, PA
• Joreca Alexandria Caldwell
• Lisa Diana Cale

• Addiction (Substance Use Disorder) Counselor in Statesville, NC
• Providers in Statesville, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.