Kantrell Deshawn Shelton, LCAS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

3029A Issued in NC

Practice address

112 E Elwood Ave
Raeford, NC 28376-2921

Phone

(910) 848-1924

Fax

(910) 848-1928

NPI assigned

Nov 28, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Future Starts Now, Inc.

  • Community/Behavioral Health Agency
  • Hope Mills, NC
  • NPI 1912874033
  NPD Authorized official

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1770828998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2959 DALMATION DR",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283484004",
            "telephone_number": "910-263-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E ELWOOD AVE",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283762921",
            "telephone_number": "910-848-1924",
            "fax_number": "910-848-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "KANTRELL",
        "middle_name": "DESHAWN",
        "name_prefix": "Mr.",
        "credential": "LCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-28",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "3029A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Phyllis Anita Shaw
• William Francis Shilkitus, PAC
• Zydet Short
• Fatimatou Sidi
• Gustavo Silveira Ribeiro, DMD
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• Addiction (Substance Use Disorder) Counselor in Raeford, NC
• Providers in Raeford, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.