Shantanique Daleja Moore King, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MT4951 Issued in FL

Practice address

3525 W Lake Mary Blvd Ste 308B
Lake Mary, FL 32746-3564

Phone

(407) 214-3471

Fax

(407) 602-0961

NPI assigned

Jun 11, 2024

Sex

Female

Sole proprietor

No

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

Enrolled in FL

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

Specialty

Marriage and Family Therapist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dna Comprehensive Therapy Services LLCGroup PAC ID 2860619632, 446 clinicians

Practice addresses (Care Compare)

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.

• Dna Comprehensive Therapy Services, LLC

  dba Elite DNA Therapy Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Myers, FL
  • NPI 1316363757
  Medicare reassignment Care Compare group NPD
• Bonita Springs Retirement Village, Inc.

  dba The Terraces at Bonita Springs

  • Skilled Nursing Facility
  • Bonita Springs, FL
  • NPI 1700126802
  NPD

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784937600000",
    "number": "1841032760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12259 FOX HOUND LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328263666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 W LAKE MARY BLVD STE 308B",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463564",
            "telephone_number": "407-214-3471",
            "fax_number": "407-602-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE KING",
        "first_name": "SHANTANIQUE",
        "middle_name": "DALEJA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2026-07-25",
        "certification_date": "2026-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rowena J Montague, PT
• Martha Patricia Montana, OT
• Sofia Gracelia Montella
• Alexandra Montero
• Nevaeh Marie Montoya I
• Moore Medical Group Inc
• Moore Medical Group Inc (CAYA Health)
• Angela Moore
• Eric A Moore, MD
• Taylor R Moore, PA

• Marriage & Family Therapist in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.