MEDICARE: SHANTE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
2	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1518781095
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHANTE PLLC

Provider Business Mailing Address
First Line	:	5995 OREN AVE N STE 108
Second Line	:
City	:	STILLWATER
State	:	MN
Zip	:	55082-5302
Country	:	US
Telephone Number	:	612-524-9237
Fax Number	:	612-314-8317

Provider Business Practice Location Address
First Line	:	5995 OREN AVE N STE 108
Second Line	:
City	:	STILLWATER
State	:	MN
Zip	:	55082-5302
Country	:	US
Telephone Number	:	612-524-9237
Fax Number	:	612-314-8317

Authorized Official
Title or Position	:	OWNER
Name	:	SHANTE SOOKHLALL HANSON
Credential	:	LMFT, RN
Telephone Number	:	612-524-9237

Provider Enumeration Date	:	11/12/2024
Last Update Date	:	01/23/2026

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Directions to “SHANTE PLLC ” Practice Location

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