Marguerite Vasshti Butler, PH.D., L.P.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4506 Issued in MN

Practice address

2120 Park Ave
Minneapolis, MN 55404-3378

Phone

(651) 774-0011

Fax

(651) 774-0606

NPI assigned

Mar 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• People Incorporated

  • Community/Behavioral Health Agency
  • Minneapolis, MN
  • NPI 1215104831
  Medicare reassignment NPD
• People Incorporated

  • Community/Behavioral Health Agency
  • New Hope, MN
  • NPI 1720356900
  NPD

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1215998166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4557 OAKLAND AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073533",
            "telephone_number": "612-227-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043378",
            "telephone_number": "651-774-0011",
            "fax_number": "651-774-0606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4557 Oakland Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554073533",
            "country_code": "US",
            "telephone_number": "612-227-0455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "MARGUERITE",
        "middle_name": "VASSHTI",
        "name_prefix": "Dr.",
        "credential": "PH.D., L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-30",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "4506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "996488600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hope Butler
• Imara Simone Butler
• Karen Havens Butler, PH.D, LP
• Kristin Butler, RD, LD, CD
• Lisa Marie Butler, RN
• McKinzy Butler, MD
• Melissa Butler, LICSW
• Molly Butler, MD
• Robert Leon Butler, LADC
• Yvonne Butler

• Clinical Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.