Individual provider Active NPI

Colleen W Butterick, ED.D.

  • Professional Counselor
  • Memphis, TN
National Provider Identifier
1891831533
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC611 Issued in TN
Practice address
641 Oakleaf Office LN Ste 2
Memphis, TN 38117-4819
Phone
(901) 542-5792
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC611 TN Primary

Addresses

Primary practice location

641 Oakleaf Office LN Ste 2
Memphis, TN 38117-4819

Mailing address

641 Oakleaf Office LN Ste 2
Memphis, TN 38117-4819
Phone (901) 542-5792

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
LPC611TNMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891831533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 OAKLEAF OFFICE LN STE 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174819",
            "telephone_number": "901-542-5792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 OAKLEAF OFFICE LN STE 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174819",
            "telephone_number": "901-542-5792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTERICK",
        "first_name": "COLLEEN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "LPC611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.