SHANTELL DIVINITY MORENO
NPI 1174011407
Counselor - Mental Health in Albuquerque, NM
About Shantell Divinity Moreno NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHANTELL DIVINITY MORENO (NPI 1174011407) is an individual mental health provider in Albuquerque, New Mexico, licensed in New Mexico (CTL0218771) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Novi.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shantell Divinity Moreno is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Shantell Moreno reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Albuquerque, NM 87102
- Reassigned Medicare billing, New Mexico enrollment
- 12 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ALBUQUERQUE, NM 87102
ALBUQUERQUE, NM 87102
ALBUQUERQUE, NM 87102
ALBUQUERQUE, NM 87102
ALBUQUERQUE, NM 87102
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shantell Moreno's NPI number?
The NPI number for Shantell Moreno is 1174011407. It was assigned to this individual provider in the NPPES registry on April 23, 2018.
Where is Shantell Moreno located?
Shantell Moreno practices at 1101 Medical Arts Ave NE, Albuquerque, NM 87102. The listed phone number is (505) 933-4639.
What is Shantell Moreno's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Shantell Moreno enrolled in Medicare?
Yes. Shantell Moreno is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Shantell Moreno's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shantell Moreno reassigns Medicare benefits to Small Steps Child Counseling, LLC (Albuquerque, NM). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shantell Moreno's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Shantell Moreno was last updated on August 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shantell Divinity Moreno · NPI 1174011407
Mental Health provider in Albuquerque, New Mexico. Individual provider, active in the CMS NPPES registry since April 23, 2018.
## Identity
- **NPI:** 1174011407 (Entity type: Individual)
- **Enumerated:** April 23, 2018
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** CTL0218771 (New Mexico)
- **Sole proprietor:** No
## Practice location
- **Address:** 1101 MEDICAL ARTS AVE NE, Albuquerque, NM 87102
- **Phone:** (505) 933-4639
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Small Steps Child Counseling, LLC (NPI 1952699654, Albuquerque, NM), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 27, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1174011407) · Data from the CMS NPPES public registry.