Active NPI
Shante Butler
- Clinical Social Worker
- Port Wentworth, GA
National Provider Identifier
1609780295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- MSW009488
- Practice address
- 64 Rice Mill Rd
Port Wentworth, GA 31407-6022 - Phone
- (912) 655-2028
- NPI assigned
- Sep 30, 2026
- Last updated
- Sep 30, 2026
- 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 | MSW009488 | GA | Primary |
Addresses
Primary practice location
64 Rice Mill Rd
Port Wentworth, GA 31407-6022
Mailing address
64 Rice Mill Rd
Port Wentworth, GA 31407-6022
Phone (912) 655-2028
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790726400000",
"number": "1609780295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 RICE MILL RD",
"city": "PORT WENTWORTH",
"state": "GA",
"postal_code": "314076022",
"telephone_number": "912-655-2028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 RICE MILL RD",
"city": "PORT WENTWORTH",
"state": "GA",
"postal_code": "314076022",
"telephone_number": "912-655-2028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "SHANTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-09-30",
"last_updated": "2026-09-30",
"certification_date": "2026-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "MSW009488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Wentworth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.