Individual provider Active NPI

Shannon Latray, LCPC, LPC, LCMHC

  • Mental Health Counselor
  • Butte, MT
National Provider Identifier
1790431096
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
BBH-LCPC-LIC-17894 Issued in MT
Practice address
4134 Wynne Ave Apt C
Butte, MT 59701-6733
Phone
(406) 560-2799
NPI assigned
Feb 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C7145 OR
Mental Health Counselor 101YM0800X 252224 AK
Mental Health Counselor 101YM0800X 12837764-6004 UT
Mental Health Counselor 101YM0800X CC6660 ME
Mental Health Counselor 101YM0800X PRC200001490 DC
Mental Health Counselor 101YM0800X 37PC00912400 NJ
Mental Health Counselor 101YM0800X 13387-MH-CC MA
Mental Health Counselor 101YM0800X LPC-21627 AZ
Mental Health Counselor 101YM0800X 5736 NH
Mental Health Counselor 101YM0800X 017983 NY
Mental Health Counselor 101YM0800X BBH-LCPC-LIC-17894 MT Primary

Addresses

Primary practice location

4134 Wynne Ave Apt C
Butte, MT 59701-6733

Mailing address

4134 Wynne Ave Apt C
Butte, MT 59701-6733
Phone (406) 560-2799

Other practice location 1

971 US Highway 202 N
Branchburg, NJ 08876-3757
Phone (406) 565-2537

Other practice location 2

418 Broadway Apt C
Albany, NY 12207-2922
Phone (406) 565-2537

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
LPC-21627AZMDMental Health Counselor
PRC200001490DCMDMental Health Counselor
13387-MH-CCMAMDMental Health Counselor
CC6660MEMDMental Health Counselor
BBH-LCPC-LIC-17894MTMDMental Health Counselor
37PC00912400NJMDMental Health Counselor
C7145ORMDMental Health Counselor
12837764-6004UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Uplift Behavioral Health PC Past Accepting new patients

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": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1790431096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4134 WYNNE AVE APT C",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597016733",
            "telephone_number": "406-560-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4134 WYNNE AVE APT C",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597016733",
            "telephone_number": "406-560-2799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "971 US Highway 202 N",
            "address_purpose": "LOCATION",
            "city": "Branchburg",
            "state": "NJ",
            "postal_code": "088763757",
            "country_code": "US",
            "telephone_number": "406-565-2537",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "418 Broadway Apt C",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122072922",
            "country_code": "US",
            "telephone_number": "406-565-2537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATRAY",
        "first_name": "SHANNON",
        "credential": "LCPC, LPC, LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-24",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C7145",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AK",
            "license": "252224",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "12837764-6004",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "CC6660",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "PRC200001490",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00912400",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "13387-MH-CC",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-21627",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "5736",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "017983",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "BBH-LCPC-LIC-17894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Butte, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.