Active NPI
Kyle Butler
- Mental Health Counselor
- Tigard, OR
National Provider Identifier
1174111611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- R9341
- Practice address
- 10580 SW McDonald St Ste 205
Tigard, OR 97224-4800 - Phone
- (801) 616-9293
- NPI assigned
- Jan 8, 2021
- Last updated
- Jun 21, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | R9341 | OR | Primary |
Addresses
Primary practice location
10580 SW McDonald St Ste 205
Tigard, OR 97224-4800
Mailing address
1112 Emmett Loop
Silverton, OR 97381-8763
Phone (801) 616-9293
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R9341 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1174111611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1112 EMMETT LOOP",
"city": "SILVERTON",
"state": "OR",
"postal_code": "973818763",
"telephone_number": "801-616-9293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10580 SW MCDONALD ST STE 205",
"city": "TIGARD",
"state": "OR",
"postal_code": "972244800",
"telephone_number": "801-616-9293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "KYLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-08",
"last_updated": "2024-06-21",
"certification_date": "2024-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "R9341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.