Provider Demographics
NPI:1306954151
Name:BUTLER-DAVIDSON COUNSELING SERVICES
Entity type:Organization
Organization Name:BUTLER-DAVIDSON COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:417-667-9608
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-0607
Mailing Address - Country:US
Mailing Address - Phone:417-667-9608
Mailing Address - Fax:417-667-9713
Practice Address - Street 1:212 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-2332
Practice Address - Country:US
Practice Address - Phone:417-667-9608
Practice Address - Fax:417-667-9713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000703101YP2500X
MO01384103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO29138012OtherBCBS OF KC
MO29138012OtherBCBS OF KC