Shantal M Childers, MS CADC II

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

221 Executive Circle
Suite 7
Savannah, GA 31406-4529

Phone

(912) 521-4301

NPI assigned

Jan 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Youth Evolution Track LLC

  • Mental Health Counselor
  • Savannah, GA
  • NPI 1558959171

  Professional

  NPD

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1528656253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 CLOVER POINT CIR",
            "city": "GUYTON",
            "state": "GA",
            "postal_code": "313127134",
            "telephone_number": "912-675-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 EXECUTIVE CIRCLE",
            "address_2": "SUITE 7",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064529",
            "telephone_number": "912-521-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "SHANTAL",
        "middle_name": "M",
        "credential": "MS CADC II",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG AND ALCOHOL",
            "identifier": "124764",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica S Cherry, LCSW
• Ritaanne Chesney, CNM
• Sonali Chhabra, MD
• John Benjamin Chiari, MD
• Heather Childers, SLP, MS
• Shelly Stewart Childers
• Children's Lung and Sleep Associates
• Childrens Eye Institute of Savannah, Inc.
• Elizabeth D Childress, NP
• Jenny Tomberlin Childs, FNP

• Addiction (Substance Use Disorder) Counselor in Savannah, GA
• Providers in Savannah, GA by specialty
• Addiction (Substance Use Disorder) Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.