Butterfly Affect

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

BUTTERFLY AFFECT

Practice address

4915 I 55 N Frontage Rd Ste C 305
Jackson, MS 39205

Phone

(769) 226-6232

NPI assigned

Dec 11, 2020

Last updated

Dec 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer GreenNPI 1770113607

Title

Member

Phone

(769) 226-6232

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Green, BCBS

  • Behavior Analyst
  • Jackson, MS
  • NPI 1770113607
  NPD Authorized official

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1831795095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 59053",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392849053",
            "telephone_number": "769-226-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 I 55 N FRONTAGE RD STE C 305",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39205",
            "telephone_number": "769-226-6232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUTTERFLY AFFECT",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "769-226-6232"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00754701",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keiella Butler, PMHNP-BC
• Lee Esther Butler
• Mindy Butler, PA-C
• Rush Sanders Butler
• Tiffany Butler
• Linda Susan Buttross, M.D.
• Megan M Butts, NP
• William Hayden Butts
• Rebecca Butz, MS, RD, LD
• Frotashia M Buxton, OT

• Adolescent and Children Mental Health Clinic/Center in Jackson, MS
• Providers in Jackson, MS by specialty
• Adolescent and Children Mental Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.