Active NPI
Shanterica Latrice Swan
- Mental Health Counselor
- Palmetto Bay, FL
National Provider Identifier
1184586042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IMH24922
- Practice address
- 9555 SW 175TH Ter # 4011
Palmetto Bay, FL 33157-5604 - Phone
- (786) 862-6699
- NPI assigned
- Dec 1, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMH24922 | FL | Primary |
Addresses
Primary practice location
9555 SW 175TH Ter # 4011
Palmetto Bay, FL 33157-5604
Mailing address
9555 SW 175TH Ter Ste 4011
Palmetto Bay, FL 33157-5604
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
532 NE 1St Dr
Florida City, FL 33034-2276
535 Mack Ave
Kingsley, MI 49649-9220
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH24922 | FL | MD | Mental Health Counselor |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767744000000",
"number": "1184586042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9555 SW 175TH TER STE 4011",
"city": "PALMETTO BAY",
"state": "FL",
"postal_code": "331575604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9555 SW 175TH TER # 4011",
"city": "PALMETTO BAY",
"state": "FL",
"postal_code": "331575604",
"telephone_number": "786-862-6699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWAN",
"first_name": "SHANTERICA",
"middle_name": "LATRICE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-12-01",
"last_updated": "2026-01-07",
"certification_date": "2026-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMH24922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Palmetto Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.