Provider Demographics
NPI:1306626866
Name:CREWS, SHANEIRIA SCOTT
Entity type:Individual
Prefix:
First Name:SHANEIRIA
Middle Name:SCOTT
Last Name:CREWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 ARLINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-3318
Mailing Address - Country:US
Mailing Address - Phone:706-590-3067
Mailing Address - Fax:
Practice Address - Street 1:1830 HICKORY SHORES BLVD
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-2511
Practice Address - Country:US
Practice Address - Phone:850-677-0302
Practice Address - Fax:850-994-4080
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YA0400X, 101YM0800X
FLSW242721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health