Provider Demographics
NPI:1093548075
Name:MEREDITH BUTLER SCROGGIN, LCSW
Entity type:Organization
Organization Name:MEREDITH BUTLER SCROGGIN, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:BUTLER
Authorized Official - Last Name:SCROGGIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:501-387-4188
Mailing Address - Street 1:900 S SHACKLEFORD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3848
Mailing Address - Country:US
Mailing Address - Phone:501-387-4188
Mailing Address - Fax:501-387-4110
Practice Address - Street 1:900 S SHACKLEFORD RD STE 300
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3848
Practice Address - Country:US
Practice Address - Phone:501-387-4188
Practice Address - Fax:501-387-4110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty