Shakeena Denise Brantley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW13077 Issued in FL

Practice address

619 S Marion Ave
Lake City, FL 32025-5808

Phone

(386) 755-3016

NPI assigned

Jan 15, 2013

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

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.

• 3 Cord Counseling

  • Mental Health Counselor
  • Altamonte Springs, FL
  • NPI 1710445044
  NPD (past) Authorized official

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1962749515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 NORTHLAKE BLVD APT 77",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327016732",
            "telephone_number": "954-494-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255808",
            "telephone_number": "386-755-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANTLEY",
        "first_name": "SHAKEENA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-15",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel C Bowen, L.M.T.
• Shelby Bowman
• Kimberly Denise Bowser, LMSW
• Kathi Bracewell
• Jalise Bradley
• Delilah Bray
• Tiffany J Brazeal
• Brent Hayden, M.D.,P.a.
• Brenda J Brickel
• Kristian Danielle Brinson

• Clinical Social Worker in Lake City, FL
• Providers in Lake City, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.