=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083584270
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BUTTERFLY EFFECTS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/11/2025
-----------------------------------------------------
Last Update Date | 11/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11240 FM 1960 RD W STE 209
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77065-3664
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-418-2978
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 350 FAIRWAY DR STE 101
-----------------------------------------------------
City | DEERFIELD BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33441-1834
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-418-2978
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BEHAVIOR TECHNICIAN
-----------------------------------------------------
Name | MCKENNA ELWOOD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 281-655-8912
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------