Provider Demographics
NPI:1689458598
Name:PURPLEBUTTERFLY, LLC
Entity Type:Organization
Organization Name:PURPLEBUTTERFLY, LLC
Other - Org Name:BUTTERFLY COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-586-1815
Mailing Address - Street 1:PO BOX 1142
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39060-1142
Mailing Address - Country:US
Mailing Address - Phone:601-622-6260
Mailing Address - Fax:
Practice Address - Street 1:90 W LAKEVIEW DR.
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-5266
Practice Address - Country:US
Practice Address - Phone:662-586-1815
Practice Address - Fax:769-241-0062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty