Individual provider Active NPI

Angela Diane McClain, LCPC, LCAC

  • Mental Health Counselor
  • Topeka, KS
National Provider Identifier
1497052005
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2329 Issued in KS
Practice address
1601 S.W 37TH Street
Topeka, KS 66611
Phone
(785) 228-5691
Fax
(785) 272-1522
NPI assigned
Feb 16, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1021 NE
Addiction (Substance Use Disorder) Counselor 101YA0400X 1043 KS
Mental Health Counselor 101YM0800X 2506 KS
Mental Health Counselor 101YM0800X 1052 NE
Mental Health Counselor 101YM0800X 2014 NE
Mental Health Counselor 101YM0800X 001340 IA
Mental Health Counselor 101YM0800X 2329 KS Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 536 KS

Addresses

Primary practice location

1601 S.W 37TH Street
Topeka, KS 66611

Mailing address

1601 S.W. 37TH Street
Topeka, KS 66611
Phone (785) 228-5691

Other identifiers 1

IdentifierTypeStateIssuer
201086680AMedicaidKS

Other names 1

  • Angela Peavy-Butcher Former name

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

LicenseStateTypeSpecialty
001340IAMDMental Health Counselor
1043KSMDProfessional Counselor
2014NEMDChiropractor
1021NEMDOccupational Therapy Assistant
2329KSMDSpeech-Language Pathologist
536KSMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1497052005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 S.W. 37TH STREET",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "66611",
            "telephone_number": "785-228-5691",
            "fax_number": "785-272-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 S.W 37TH STREET",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "66611",
            "telephone_number": "785-228-5691",
            "fax_number": "785-272-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLAIN",
        "first_name": "ANGELA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "LCPC, LCAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-16",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "1021",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "1043",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KS",
            "license": "2506",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1052",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2014",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001340",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KS",
            "license": "2329",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "536",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201086680A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "PEAVY-BUTCHER",
            "credential": "LCPC, LCAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Topeka, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.