Provider Demographics
NPI:1013631241
Name:THE BUTTERFLY EFFECT GROUP, LLC
Entity Type:Organization
Organization Name:THE BUTTERFLY EFFECT GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:678-592-0636
Mailing Address - Street 1:6301 FIVE OAKS WAY
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-8175
Mailing Address - Country:US
Mailing Address - Phone:678-592-0636
Mailing Address - Fax:
Practice Address - Street 1:6301 FIVE OAKS WAY
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-8175
Practice Address - Country:US
Practice Address - Phone:678-592-0636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management