MEDICARE: SHANTEL SHELTON-ROGERS

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	104100000X	Social Worker	18706	LA
2	171M00000X	Case Manager/Care Coordinator	18706	LA

General Provider Information

NPI Number	:	1780240390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANTEL SHELTON-ROGERS

Provider Business Mailing Address
First Line	:	3004 KNIGHT ST STE 149
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2502
Country	:	US
Telephone Number	:	318-227-8390
Fax Number	:	318-429-2414

Provider Business Practice Location Address
First Line	:	3004 KNIGHT ST STE 149
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2502
Country	:	US
Telephone Number	:	318-227-8390
Fax Number	:	318-429-2414

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2019
Last Update Date	:	12/15/2025

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