Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANTELL DIVINITY MORENO
DeactivatedSHANTELL DIVINITY MORENO is a Mental Health Counselor healthcare provider located in ALBUQUERQUE, New Mexico. NPI 1174011407 is deactivated in the NPPES registry. Verify at CMS.
Mental Health Counselor · ALBUQUERQUE, NM
This NPI has been deactivated.
The record was deactivated on July 22, 2021.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1174011407
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 23, 2018 (3.2465753424658 yrs)
- Last Updated
- Jul 30, 2025
- Deactivated
- Jul 22, 2021
- License
-
CTB20250475 (NM)
Practice Information
- Address
-
1101 MEDICAL ARTS AVE NEALBUQUERQUE, NM, 87102Browse NM providers · Browse ZIP 87102
- Phone
- 5059334639
- Primary Specialty
-
Mental Health Counselor
101YM0800X
- Additional Specialty
- Mental Health Counselor
Other Mental Health Counselor Providers in ALBUQUERQUE, NM
| Name | Credential | NPI |
|---|---|---|
| MR. STEVEN J LOCKE | LPCC | 1821086232 |
| RODNEY LEE REINHARDT | MA, LPC | 1588653000 |
| MS. LINDA ANN FALEN | LPCC | 1891784328 |
| SHANNON MARIE KIMBRO | LMHC | 1265421622 |
| TEDDY WATSON | LPCC | 1730170739 |
| SANDRA K PRATT | LMT, LMFT, SEP, OB | 1124019120 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.