MEDICARE: BUTLER PSYCHOLOGICAL GROUP, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	34589	TX

General Provider Information

NPI Number	:	1740549823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUTLER PSYCHOLOGICAL GROUP, PLLC

Provider Business Mailing Address
First Line	:	4031 FOREST TEAL CT
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-8648
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4031 FOREST TEAL CT
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-8648
Country	:	US
Telephone Number	:	832-651-5518
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	DR. EBONI TIANA BUTLER
Credential	:	PSY.D.
Telephone Number	:	832-386-9449

Provider Enumeration Date	:	05/10/2012
Last Update Date	:	04/18/2026

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