Healthcare Provider Details

I. General information

NPI: 1316784333
Provider Name (Legal Business Name): MEGAN J. SHEPHERD COUNSELING & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2024
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:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MEGAN SHEPHERD
Title or Position: OWNER, LPCC
Credential: LPCC
Phone: 513-394-9864