MEDICARE: RACHEL DAWN SHEPHERD MSW

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

General Provider Information

NPI Number	:	1326331927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL DAWN SHEPHERD MSW

Provider Business Mailing Address
First Line	:	2920 SHERIDAN LAKE RD
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-5350
Country	:	US
Telephone Number	:	605-343-7262
Fax Number	:	605-343-7293

Provider Business Practice Location Address
First Line	:	2920 SHERIDAN LAKE RD
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-5350
Country	:	US
Telephone Number	:	605-348-0477
Fax Number	:	605-348-0479

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

Provider Enumeration Date	:	05/16/2011
Last Update Date	:	12/10/2014

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