Healthcare Provider Details

I. General information

NPI: 1669575759
Provider Name (Legal Business Name): NICK T BUTCHER M.A., L.C.P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12185 S FOXRIDGE DR
OLATHE KS
66062-1089
US

IV. Provider business mailing address

12185 S FOXRIDGE DR
OLATHE KS
66062-1089
US

V. Phone/Fax

Practice location:
  • Phone: 913-440-9137
  • Fax: 913-490-3168
Mailing address:
  • Phone: 913-440-9137
  • Fax: 913-490-3168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberTPMC2699
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1999142227
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC0022227
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number773
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: