Active NPI
Shastity Claiborne
- Addiction (Substance Use Disorder) Counselor
- Tallulah, LA
National Provider Identifier
1841868031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 171M00000X
- Practice address
- 410 E Askew St
Tallulah, LA 71282-3706 - Phone
- (318) 574-2320
- NPI assigned
- Jun 14, 2021
- Last updated
- Jun 14, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 171M00000X | LA | Primary |
Addresses
Primary practice location
410 E Askew St
Tallulah, LA 71282-3706
Mailing address
410 E Askew St
Tallulah, LA 71282-3706
Phone (318) 574-2320
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972980514 | Medicaid | LA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | ConnectURL | ||
| CONNECT URL | CONNECTURL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 171M00000X | LA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623628800000",
"number": "1841868031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 E ASKEW ST",
"city": "TALLULAH",
"state": "LA",
"postal_code": "712823706",
"telephone_number": "318-574-2320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 E ASKEW ST",
"city": "TALLULAH",
"state": "LA",
"postal_code": "712823706",
"telephone_number": "318-574-2320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAIBORNE",
"first_name": "SHASTITY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-14",
"last_updated": "2021-06-14",
"certification_date": "2021-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "LA",
"license": "171M00000X",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1972980514",
"state": "LA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "ConnectURL",
"affiliation": "N",
"address_1": "410 E Askew St",
"city": "Tallulah",
"state": "LA",
"country_code": "US",
"postal_code": "712823706",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "CONNECTURL",
"affiliation": "N",
"address_1": "410 E Askew St",
"city": "Tallulah",
"state": "LA",
"country_code": "US",
"postal_code": "712823706",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tallulah, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.