Shantel Marie Basurto, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

008183 Issued in IA

Practice address

3316 Cedar Heights Dr
Suite a
Cedar Falls, IA 50613-6083

Phone

(319) 504-4593

Fax

(319) 274-9147

NPI assigned

Oct 14, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shantel Marie Leary Former name

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.

• Basurto Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Cedar Falls, IA
  • NPI 1750945135
  NPD (past) Authorized official

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1871964007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 CEDAR HEIGHTS DR STE A",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506136083",
            "telephone_number": "319-504-4593",
            "fax_number": "319-260-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 CEDAR HEIGHTS DR",
            "address_2": "SUITE A",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506136083",
            "telephone_number": "319-504-4593",
            "fax_number": "319-274-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASURTO",
        "first_name": "SHANTEL",
        "middle_name": "MARIE",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "008183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0707633",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANTEL",
            "last_name": "LEARY",
            "middle_name": "MARIE",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• April Lee Barnett
• Emma Rae Barr
• Cassady A Bartlett, DPT
• Sydney Renee Barton
• Basurto Behavioral Health, LLC
• Andrew Thomas Batovsky, NP
• Cathryn Baumgartner
• Gary Beetner, MD
• Cameron James Belgio
• Derrick James Benner, D.C.

• All providers in Cedar Falls, IA
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.