MEDICARE: SHAMARA BUTLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041S0200X	School Social Worker

General Provider Information

NPI Number	:	1497691950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAMARA BUTLER

Provider Business Mailing Address
First Line	:	1015 SNELLING AVE S
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-2447
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1015 SNELLING AVE S
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-2447
Country	:	US
Telephone Number	:	651-744-4636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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Directions to “ SHAMARA BUTLER ” Practice Location

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