MCK Behavior Services LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

MCK BEHAVIOR SERVICES LLC

Practice address

2843 Stage Center Dr
Suite #3
Bartlett, TN 38134-4697

Phone

(901) 387-0300

Fax

(901) 339-6611

NPI assigned

Oct 6, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Maurice Butler Jr., BCBA

Title

Executive Director

Phone

(901) 387-0300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1720458565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380880280",
            "telephone_number": "901-387-0300",
            "fax_number": "901-339-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2843 STAGE CENTER DR",
            "address_2": "SUITE #3",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381344697",
            "telephone_number": "901-387-0300",
            "fax_number": "901-339-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCK BEHAVIOR SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "MAURICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "901-387-0300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H445397",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison McCharen, PA-C
• Brandon Elllis McCord, M.S., BCBA
• James McDermott
• Mary Jane McDonald, DPH
• Candance Lee McGowen, FNP-C
• Tyler Lee McNeely, MD
• Courtney Wechsler McShan, PT
• Lewis Todd McWilliams, PHARMD
• Kathryn S Mead, D.C.
• Medex Biocare Pharmacy, LLC.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.