Provider Demographics
NPI:1639235104
Name:MYERS, BUTLER & ASSOCIATES COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:MYERS, BUTLER & ASSOCIATES COUNSELING SERVICES, INC.
Other - Org Name:MBA COUNSELING SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:OPHELIA
Authorized Official - Middle Name:RAINEY
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MSSW,LCSW,ACSW, MPA
Authorized Official - Phone:615-366-1948
Mailing Address - Street 1:2479 MURFREESBORO PIKE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-3554
Mailing Address - Country:US
Mailing Address - Phone:615-366-1948
Mailing Address - Fax:615-367-4143
Practice Address - Street 1:117 LYLE LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-4732
Practice Address - Country:US
Practice Address - Phone:615-366-1948
Practice Address - Fax:615-367-4143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN04160661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
493743000018805OtherMAGELLAN BEHAVIORAL HEALT
TN=========OtherTENNCARE