Shirley Rae Butcher, LPCC, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC01420 Issued in MN

Practice address

1821 University Ave W
Suite N-385
Saint Paul, MN 55104-3489

Phone

(612) 326-7571

Fax

(651) 647-9147

NPI assigned

Feb 6, 2013

Last updated

Aug 6, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

Mental Health Counselor

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Transformation House IncGroup PAC ID 1850750696, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Transformation House Inc

  dba Agape Health and Wellness

  • Mental Health Counselor
  • Anoka, MN
  • NPI 1417768771
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1891034120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W",
            "address_2": "SUITE N-385",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043489",
            "telephone_number": "612-326-7571",
            "fax_number": "651-647-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W",
            "address_2": "SUITE N-385",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043489",
            "telephone_number": "612-326-7571",
            "fax_number": "651-647-9147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6043 Hudson Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551251033",
            "country_code": "US",
            "telephone_number": "651-925-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3329 University Ave SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554143325",
            "country_code": "US",
            "telephone_number": "612-454-2260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2807 Brookdale Dr",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Park",
            "state": "MN",
            "postal_code": "554441844",
            "country_code": "US",
            "telephone_number": "763-237-9898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2215 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Brainerd",
            "state": "MN",
            "postal_code": "564015549",
            "country_code": "US",
            "telephone_number": "218-454-1010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTCHER",
        "first_name": "SHIRLEY",
        "middle_name": "RAE",
        "credential": "LPCC, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-06",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303272",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC01420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Bushey, LICSW
• Carol L Busman, CNS
• Janelle Melody Bussert, MT-BC
• Barbara L Butcher, MD
• Krystal Ann Butcher, PA
• Michael S. Butchko, PH.D.
• Michael S Butler, PA-C
• Robert R Butler Jr., MD
• Shamara Butler
• Shelley Joan Butler, PA-C

• Mental Health Counselor in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.