Provider Demographics
NPI:1366129785
Name:ABSTON, SHANTEL (LICSW)
Entity type:Individual
Prefix:
First Name:SHANTEL
Middle Name:
Last Name:ABSTON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10693 RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-9474
Mailing Address - Country:US
Mailing Address - Phone:251-442-4993
Mailing Address - Fax:
Practice Address - Street 1:10693 RIDGEVIEW DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-9474
Practice Address - Country:US
Practice Address - Phone:251-442-4993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4571C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical