Healthcare Provider Details

I. General information

NPI: 1699316026
Provider Name (Legal Business Name): REBECCA SINNETT SHEPHERD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA NICHOLE SINNETT

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BREWSTER BLVD
CAMP LEJEUNE NC
28547-2538
US

IV. Provider business mailing address

100 BREWSTER BLVD
CAMP LEJEUNE NC
28547-2538
US

V. Phone/Fax

Practice location:
  • Phone: 910-450-2648
  • Fax:
Mailing address:
  • Phone: 910-450-2648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC018449
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: