Active NPI
Shannon Latray, LCPC, LPC, LCMHC
- Mental Health Counselor
- Butte, MT
National Provider Identifier
1790431096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- BBH-LCPC-LIC-17894
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 11
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-21627 | AZ | MD | Mental Health Counselor |
| PRC200001490 | DC | MD | Mental Health Counselor |
| 13387-MH-CC | MA | MD | Mental Health Counselor |
| CC6660 | ME | MD | Mental Health Counselor |
| BBH-LCPC-LIC-17894 | MT | MD | Mental Health Counselor |
| 37PC00912400 | NJ | MD | Mental Health Counselor |
| C7145 | OR | MD | Mental Health Counselor |
| 12837764-6004 | UT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Adult Mental Health Clinic/Center
- Bethesda, MD
- NPI 1629740410
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.