Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Shantayia Neal Provost, LCSW

Individual provider Clinical Social Worker · NPI 1689350084

Mrs. Shantayia Neal Provost, LCSW is a Clinical Social Worker in Douglasville, Georgia. Licensed in Utah. Registered with an NPI since 2023.

Licensed in
UT
In the registry since
2023
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

4595 Flat Willow Pl
Douglasville, GA 30135-8646
Phone: (404) 548-5761
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 184759-3102 (UT)

Record details

NPI number1689350084
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJune 22, 2023
Last updated in NPPESJune 22, 2023
Certification dateJune 22, 2023

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