Active NPI
Terissa Lynne Upchurch-Butler, PH.D, LPC, LIMHP,
- Professional Counselor
- Cottondale, AL
National Provider Identifier
1235804451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4104
- Practice address
- 5927 University Blvd E
Cottondale, AL 35453-1644 - Phone
- (205) 534-1938
- NPI assigned
- Aug 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4104 | AL | Primary |
Addresses
Primary practice location
5927 University Blvd E
Cottondale, AL 35453-1644
Mailing address
PO Box 71382
Tuscaloosa, AL 35407-1382
Phone (205) 534-1938
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4104 | AL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628553600000",
"number": "1235804451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 71382",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354071382",
"telephone_number": "205-534-1938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5927 UNIVERSITY BLVD E",
"city": "COTTONDALE",
"state": "AL",
"postal_code": "354531644",
"telephone_number": "205-534-1938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UPCHURCH-BUTLER",
"first_name": "TERISSA",
"middle_name": "LYNNE",
"name_prefix": "Dr.",
"credential": "PH.D, LPC, LIMHP,",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-10",
"last_updated": "2021-08-10",
"certification_date": "2021-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AL",
"license": "4104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cottondale, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.