MEDICARE: NICK T BUTCHER M.A., L.C.P.C.

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	101YP2500X	Professional Counselor	1999142227	MO
2	101YP2500X	Professional Counselor	LPC0022227	CO
3	101YP2500X	Professional Counselor	773	KS
4	101YM0800X	Mental Health Counselor	TPMC2699	FL

General Provider Information

NPI Number	:	1669575759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICK T BUTCHER M.A., L.C.P.C.

Provider Business Mailing Address
First Line	:	12185 S FOXRIDGE DR
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-1089
Country	:	US
Telephone Number	:	913-440-9137
Fax Number	:	913-490-3168

Provider Business Practice Location Address
First Line	:	12185 S FOXRIDGE DR
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-1089
Country	:	US
Telephone Number	:	913-440-9137
Fax Number	:	913-490-3168

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	03/25/2026

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