MEDICARE: BUTLER BEHAVIORAL HEALTH 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	251B00000X	Case Management Agency
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1982078283
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUTLER BEHAVIORAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	4849 N MESA ST STE 201
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-5919
Country	:	US
Telephone Number	:	915-351-6600
Fax Number	:	915-351-6601

Provider Business Practice Location Address
First Line	:	1900 DENVER AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902
Country	:	US
Telephone Number	:	915-544-4000
Fax Number	:	915-351-6601

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JACOB I BUTLER
Credential	:	APRN
Telephone Number	:	915-351-6600

Provider Enumeration Date	:	11/24/2015
Last Update Date	:	02/12/2026

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