Active NPI
Shantel Green
- Clinical Social Worker
- Fort Worth, TX
National Provider Identifier
1396573580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 106566
- Practice address
- 4500 Mercantile Plaza Dr Ste 300
Fort Worth, TX 76137-4206 - Phone
- (817) 482-0537
- NPI assigned
- Jul 22, 2024
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 106566 | TX | Primary |
Addresses
Primary practice location
4500 Mercantile Plaza Dr Ste 300
Fort Worth, TX 76137-4206
Mailing address
1751 River Run Ste 200
Fort Worth, TX 76107-6670
Phone (817) 500-0785
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106566 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simply Therapeutic Counseling, PLLC | Clinical | Current | Accepting new patients |
Locations
4500 Mercantile Plaza Dr
Ste 300
Ft Worth, TX 76137
Phone (469) 688-9501
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.
-
- Clinical Social Worker
- Fort Worth, TX
- NPI 1316896145
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765843200000",
"number": "1396573580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1751 RIVER RUN STE 200",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761076670",
"telephone_number": "817-500-0785",
"fax_number": "817-241-1963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 MERCANTILE PLAZA DR STE 300",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761374206",
"telephone_number": "817-482-0537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "SHANTEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-22",
"last_updated": "2025-12-16",
"certification_date": "2025-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "106566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.