Individual provider Active NPI

Shantelle M Wells

  • Professional Counselor
  • Kansas City, MO
National Provider Identifier
1750861480
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2018027693 Issued in MO
Practice address
3801 Blue Pkwy
Kansas City, MO 64130-2807
Phone
(816) 599-5252
NPI assigned
Aug 21, 2018
Last updated
Aug 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2018027693 MO Primary

Addresses

Primary practice location

3801 Blue Pkwy
Kansas City, MO 64130-2807

Mailing address

108 SE Rose Garden LN
Lees Summit, MO 64064-2802
Phone (816) 878-3945

Other practice location 1

108 SE Rose Garden Ln
Lees Summit, MO 64064-2802
Phone (816) 878-3945

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
2018027693MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Restoring Pathways Counseling Services, LLC Professional 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": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1750861480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 SE ROSE GARDEN LN",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642802",
            "telephone_number": "816-878-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 BLUE PKWY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641302807",
            "telephone_number": "816-599-5252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 SE Rose Garden Ln",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640642802",
            "country_code": "US",
            "telephone_number": "816-878-3945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "SHANTELLE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2018027693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.