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General NPI Number Information
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NPI Number | 1184565681
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Entity Type | Individual
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Provider Name | KATRINA SHEPHERD
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Gender | Female
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Dates
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Enumeration Date | 04/01/2026
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Last Update Date | 04/01/2026
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Provider Practice Location Address
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Address Line | 4750 HARTLAND PKWY STE 264
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City | LEXINGTON
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State | KY
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Zip | 40515-1558
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Country | US
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Telephone | 859-412-1603
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Fax |
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Provider Business Mailing Address
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Address Line | 1725 HOUNDSTOOTH GLN
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City | LEXINGTON
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State | KY
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Zip | 40515-1301
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Country | US
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Telephone | 859-412-1536
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Fax | 859-809-2260
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW00001434
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License Number State | KY
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