Individual provider Active NPI

Shantelle Harrison, LCSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1467107045
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW007794 Issued in GA
Practice address
830 Glenwood Ave SE Ste 510
Atlanta, GA 30316-2176
Phone
(470) 377-1795
NPI assigned
Feb 13, 2022
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW007794 GA Primary

Addresses

Primary practice location

830 Glenwood Ave SE Ste 510
Atlanta, GA 30316-2176

Mailing address

830 Glenwood Ave SE Ste 510
Atlanta, GA 30316-2176
Phone (470) 377-1795

Other identifiers 2

IdentifierTypeStateIssuer
5535COtherALLICENSE
CSW007794OtherGALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20251015002981 GA Practitioner - Clinical Social Worker 8022496314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5284 Floyd Rd SW
Unit 233
Mableton, GA 30126-6102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW007794GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Enrich Therapy Group LLC Clinical CurrentSince Aug 22, 2025 Accepting new patients

Locations

830 Glenwood Ave SE
Ste 510
Atlanta, GA 30316

5284 Floyd Rd SW
Unit 233
Mableton, GA 30126
Phone (252) 903-1480

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1644710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1467107045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 GLENWOOD AVE SE STE 510",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162176",
            "telephone_number": "470-377-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 GLENWOOD AVE SE STE 510",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162176",
            "telephone_number": "470-377-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "SHANTELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-13",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5535C",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "CSW007794",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.