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General NPI Number Information
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NPI Number | 1124870126
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Entity Type | Organization
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Legal Business Name | SHEPPARD COUNSELING LLC
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Dates
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Enumeration Date | 04/03/2024
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Last Update Date | 04/03/2024
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Provider Practice Location Address
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Address Line | 87 SORRENTO DR
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City | CAMDENTON
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State | MO
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Zip | 65020-4759
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Country | US
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Telephone | 573-932-4676
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Fax | 573-515-1037
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Provider Business Mailing Address
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Address Line | 252 LONE WOLF DR
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City | GRAVOIS MILLS
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State | MO
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Zip | 65037-6631
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Country | US
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Telephone | 636-388-3521
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Fax | 573-515-1037
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Authorized Official
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Title or Position | OFFICE ADMIN
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Name | KRISTIN E ALBERTIN
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Credential |
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Telephone | 573-932-4676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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