Healthcare Provider Details

I. General information

NPI: 1972670909
Provider Name (Legal Business Name): BUTTS, LINDGREN & ASSOCIATES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1884 BERKSHIRE LN N
PLYMOUTH MN
55441-3723
US

IV. Provider business mailing address

PO BOX 20667
BLOOMINGTON MN
55420-0667
US

V. Phone/Fax

Practice location:
  • Phone: 763-559-5677
  • Fax: 763-559-2116
Mailing address:
  • Phone: 952-888-3511
  • Fax: 952-888-3088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1015728-1-CDT
License Number StateMN

VIII. Authorized Official

Name: MS. SUSAN J TOSTEVIN
Title or Position: OWNER
Credential: L.A.D.C.
Phone: 952-888-3511