Provider Demographics
NPI:1164801304
Name:STANTON, SHAWN CHRISTIAN
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:CHRISTIAN
Last Name:STANTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 CAMINO GARDENS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5828
Mailing Address - Country:US
Mailing Address - Phone:561-414-1926
Mailing Address - Fax:
Practice Address - Street 1:399 CAMINO GARDENS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5828
Practice Address - Country:US
Practice Address - Phone:561-414-1926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW66651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical