Individual provider Active NPI

McKenna Marie Butcher, LGSW

  • Clinical Social Worker
  • Minnetonka, MN
National Provider Identifier
1093633745
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34414 Issued in MN
Practice address
12400 Whitewater Dr Ste 140
Minnetonka, MN 55343-4168
Phone
(651) 313-8080
NPI assigned
Jul 9, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34414 MN Primary

Addresses

Primary practice location

12400 Whitewater Dr Ste 140
Minnetonka, MN 55343-4168

Mailing address

12400 Whitewater Dr Ste 140
Minnetonka, MN 55343-4168

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

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD Clinical PastSince Apr 13, 2026 Accepting new patients
Ellie Family Services, PLLP PastSince Dec 27, 2023 Accepting new patients

Organizations & group practices 2

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": "1783555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1093633745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 WHITEWATER DR STE 140",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553434168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 WHITEWATER DR STE 140",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553434168",
            "telephone_number": "651-313-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTCHER",
        "first_name": "MCKENNA",
        "middle_name": "MARIE",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-09",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "34414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.