Shanelle Amber Benton, CSW / PSR INSTRUCTOR
Individual provider Active NPI Case Manager/Care Coordinator · Grants, NM
NPI 1013641521 · NPPES record last updated Jul 20, 2022
Key facts
- NPI
- 1013641521
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- License
- 171M00000X (NM)
- Practice address
- 1040 Sakelares Blvd
Grants, NM 87020-3819 - Phone
- (505) 287-2273
- Fax
- (505) 287-2403
- NPI assigned
- Jul 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 171M00000X | NM | MD | Case Manager/Care Coordinator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Case Manager/Care Coordinator | 171M00000X | 171M00000X | NM | Yes |
Addresses
Primary practice location
1040 Sakelares Blvd
Grants, NM 87020-3819
Mailing address
1040 Sakelares Blvd
Grants, NM 87020-3819
Phone (505) 287-2273
Other providers in Grants, NM
- Lita C Bailly
- Alicia Renee Balok
- Jeremy Michael Barnes
- Noelle Baroody
- Tamara Bennett
- Robin Simon Berrin
- Bestcare Pharmacy Grants LLC
- Bethphage
- Bethphage Mission West
- Beverly Michael
All providers in Grants, NM · Case Manager/Care Coordinator in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.