Active NPI
Katie Butusov
- Mental Health Counselor
- Downers Grove, IL
National Provider Identifier
1417683236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1323 Butterfield Rd Ste 114
Downers Grove, IL 60515-5620 - Phone
- (630) 541-9666
- NPI assigned
- Jul 25, 2022
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
1323 Butterfield Rd Ste 114
Downers Grove, IL 60515-5620
Mailing address
1323 Butterfield Rd Ste 114
Downers Grove, IL 60515-5620
Phone (630) 541-9666
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Root Therapy | Mental Health | Current | Accepting new patients |
Locations
1323 Butterfield Rd
Ste 114
Downers Grove, IL 60515
Phone (630) 541-9666
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658707200000",
"number": "1417683236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1323 BUTTERFIELD RD STE 114",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605155620",
"telephone_number": "630-541-9666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1323 BUTTERFIELD RD STE 114",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605155620",
"telephone_number": "630-541-9666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTUSOV",
"first_name": "KATIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-25",
"last_updated": "2022-07-25",
"certification_date": "2022-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Downers Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.