Healthcare Provider Details

I. General information

NPI: 1295496511
Provider Name (Legal Business Name): MEGAN SHEPHERD LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2022
Last Update Date: 09/01/2025
Certification Date: 09/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 MOUNTAIN ROAD PL NE STE R
ALBUQUERQUE NM
87110-7845
US

IV. Provider business mailing address

2775 ORCHARD RUN RD STE 341
DAYTON OH
45449-2831
US

V. Phone/Fax

Practice location:
  • Phone: 575-741-6376
  • Fax:
Mailing address:
  • Phone: 937-503-7437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2404019
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: