Active NPI
Robert Leon Butler, LADC
- Addiction (Substance Use Disorder) Counselor
- Minneapolis, MN
National Provider Identifier
1982834495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 302499
- Practice address
- 1121 Jackson St NE
105
Minneapolis, MN 55413-1672 - Phone
- (612) 977-1814
- Fax
- (612) 236-1701
- NPI assigned
- Jul 17, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 302499 | MN | Primary |
Addresses
Primary practice location
1121 Jackson St NE
105
Minneapolis, MN 55413-1672
Mailing address
741 Fuller Ave
Saint Paul, MN 55104-4832
Phone (612) 229-0795
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
| License | State | Type | Specialty |
|---|---|---|---|
| 302499 | MN | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247788800000",
"number": "1982834495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "741 FULLER AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551044832",
"telephone_number": "612-229-0795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1121 JACKSON ST NE",
"address_2": "105",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554131672",
"telephone_number": "612-977-1814",
"fax_number": "612-236-1701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "ROBERT",
"middle_name": "LEON",
"credential": "LADC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-17",
"last_updated": "2009-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "302499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.