Individual provider Active NPI

Shantel Lashay Chapman, LMHC

  • Mental Health Counselor
  • Fort Myers, FL
National Provider Identifier
1205570645
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
24083 Issued in FL
Practice address
3026 Royal Palm Ave
Fort Myers, FL 33901-7335
Phone
(239) 848-0469
NPI assigned
Apr 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 24083 FL Primary

Addresses

Primary practice location

3026 Royal Palm Ave
Fort Myers, FL 33901-7335

Mailing address

3026 Royal Palm Ave
Fort Myers, FL 33901-7335
Phone (239) 848-0469

Other names 1

  • Shantel Chapman Wiley Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241021000153 FL Practitioner - Mental Health Counselor 2163954777 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24083FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Mental Health Services - FL Gulf SW LLC CurrentSince Jun 2, 2025 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Sep 20, 2024 Accepting new patients
Optimum Healing Circle, LLC Mental Health CurrentSince Nov 10, 2024 Accepting new patients

Locations

5350 Gulf of Mexico Dr
Ste 203
Longboat Key, FL 34228
Phone (941) 210-0384

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

Organizations & group practices 3

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": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1205570645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3026 ROYAL PALM AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017335",
            "telephone_number": "239-848-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3026 ROYAL PALM AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017335",
            "telephone_number": "239-848-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPMAN",
        "first_name": "SHANTEL",
        "middle_name": "LASHAY",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-22",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "24083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANTEL",
            "last_name": "WILEY",
            "middle_name": "CHAPMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.