Anthony Martin Butler, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

29702 Issued in MN

Practice address

2864 Middle St Ste 100
Little Canada, MN 55117-1411

Phone

(651) 493-2055

Fax

(651) 340-8632

NPI assigned

Jul 5, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Peak Behavioral Health, LLC

  • Marriage & Family Therapist
  • Little Canada, MN
  • NPI 1053879023

  Clinical

  NPD (past)

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

{
    "created_epoch": "1625443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625443200000",
    "number": "1437720133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45415 LAMPLIGHT DR",
            "city": "OTTERTAIL",
            "state": "MN",
            "postal_code": "565719500",
            "telephone_number": "646-249-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2864 MIDDLE ST STE 100",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551171411",
            "telephone_number": "651-493-2055",
            "fax_number": "651-340-8632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7785 Saint Gertrude Ave",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "ND",
            "postal_code": "585644103",
            "country_code": "US",
            "telephone_number": "701-597-3419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2046 125th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Watford City",
            "state": "ND",
            "postal_code": "588549230",
            "country_code": "US",
            "telephone_number": "701-597-3419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "ANTHONY",
        "middle_name": "MARTIN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-05",
        "last_updated": "2021-07-05",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "6072",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Blaisdell, PT
• Paige Blasing, LPCC, LADC
• Abdikadar Bouraleh
• Taylor Jane Brunn
• Labibah Mazen Buraik, MSW, LGSW
• Vishal Chandra
• Karston John Chara, MA
• Huang-Joung Chen, L.AC.
• Mary Feng Chen
• Saream Chhith, MSW

• Clinical Social Worker in Little Canada, MN
• Providers in Little Canada, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2021; 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.