Shantell Byrd

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW124790 Issued in CA

Practice address

2550 E Foothill Blvd
Pasadena, CA 91107-3406

Phone

(626) 649-9796

NPI assigned

Aug 7, 2020

Reactivated

Oct 18, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Pacific Clinics

  • Community/Behavioral Health Agency
  • Campbell, CA
  • NPI 1255496105
  Medicare reassignment NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1336458934
  NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Santa Fe Springs, CA
  • NPI 1588322044
  NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Pasadena, CA
  • NPI 1992463020
  NPD
• Salt Marriage and Family Therapy

  • Marriage & Family Therapist
  • Long Beach, CA
  • NPI 1306660774
  NPD (past)
• Salt Marriage and Family Therapy Inc

  • Marriage & Family Therapist
  • Long Beach, CA
  • NPI 1467910208
  NPD (past)

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1801406426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3881 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900621105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 E FOOTHILL BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073406",
            "telephone_number": "626-649-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRD",
        "first_name": "SHANTELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "deactivation_date": "2021-10-04",
        "reactivation_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW103732",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW124790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine R Butler
• Christopher Jay Butler, MPT
• Heather Lee Butler, MD
• Kelley Butler, LCSW
• Michael S Butnik, MFT
• Charlotte Anne Byron, RN, MSN, FNP
• Susan Gail Byron, MFT
• Sangho Byun, D.D.S.
• C&H Solutions
• C7 Surgical Solutions Inc

• Clinical Social Worker in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.