Individual provider Active NPI

Shantele Abraham

  • Case Manager/Care Coordinator
  • Lake Charles, LA
National Provider Identifier
1700314283
Registry record updated Mar 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1202 Kirkman St Ste C
Lake Charles, LA 70601-5391
Phone
(337) 990-5305
NPI assigned
May 30, 2017
Last updated
Mar 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 5176 LA
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

1202 Kirkman St Ste C
Lake Charles, LA 70601-5391

Mailing address

4327 Presley Park Dr
Lake Charles, LA 70615-3066
Phone (337) 853-9880

Other practice location 1

1715 Common St
Lake Charles, LA 70601-6135
Phone (337) 439-5861

Other practice location 2

315 Alamo St
Lake Charles, LA 70601-8528
Phone (337) 513-6121

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

LicenseStateTypeSpecialty
5176LAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Louisiana AIDS Council Past Accepting new patients

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": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741478400000",
    "number": "1700314283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4327 PRESLEY PARK DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706153066",
            "telephone_number": "337-853-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 KIRKMAN ST STE C",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015391",
            "telephone_number": "337-990-5305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1715 Common St",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706016135",
            "country_code": "US",
            "telephone_number": "337-439-5861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 Alamo St",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706018528",
            "country_code": "US",
            "telephone_number": "337-513-6121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "SHANTELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2025-03-09",
        "certification_date": "2025-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "5176",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.

Verify at the official NPI Registry.