Shontae Stallworth, BACHELORS PSYCHOLOGY

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3013 20TH St Ste a
Metairie, LA 70002-4990

Phone

(504) 905-1280

NPI assigned

Nov 15, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1104641026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 CATALINA DR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701143309",
            "telephone_number": "504-905-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3013 20TH ST STE A",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700024990",
            "telephone_number": "504-905-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLWORTH",
        "first_name": "SHONTAE",
        "name_prefix": "Ms.",
        "credential": "BACHELORS PSYCHOLOGY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Metairie, LA
• Providers in Metairie, LA by specialty
• Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.