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 is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shantell Divinity Moreno is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
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 4 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
- **Medical school:** Other, class of 2021
## 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.