Shanita Shantelle Brown, PHD, LCMHC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

14463 Issued in NC

Practice address

6845 Knightdale Blvd Ste 104
Knightdale, NC 27545-9800

Phone

(919) 604-5800

NPI assigned

Dec 17, 2012

Sex

Female

Sole proprietor

No

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

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wake Counseling and Mediation, PLLC

  • Mental Health Counselor
  • Apex, NC
  • NPI 1013349356
  NPD (past)

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1134465339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 LANDSHIRE VIEW LN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276168899",
            "telephone_number": "919-604-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6845 KNIGHTDALE BLVD STE 104",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275459800",
            "telephone_number": "919-604-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Lake Boone Trl",
            "address_2": "100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276072934",
            "country_code": "US",
            "telephone_number": "919-865-8710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SHANITA",
        "middle_name": "SHANTELLE",
        "name_prefix": "Dr.",
        "credential": "PHD, LCMHC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-17",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "14463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane M Bomba, SLP-CF
• Diona Boone
• Christopher Cole Bradburn, D.C.
• Pamela Renee Bredy, RN, BSN, PMHNP-BC
• Dipa Desai Brown, PTA
• Patrick Gregory Bruff, NP
• Keisha Hinton Bryan, LCSW, LCAS
• Christopher Scott Buchanan, PHARM D.
• Sara A Buchenberger, MA, LCMHCA, NCC
• Chrystal Althea Buckrham, SLP

• Mental Health Counselor in Knightdale, NC
• Providers in Knightdale, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.