=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316784333
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEGAN J. SHEPHERD COUNSELING & WELLNESS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/09/2024
-----------------------------------------------------
Last Update Date | 09/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1209 MOUNTAIN ROAD PL NE STE R
-----------------------------------------------------
City | ALBUQUERQUE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87110-7845
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-741-6376
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2775 ORCHARD RUN RD STE 341
-----------------------------------------------------
City | DAYTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45449-2831
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER, LPCC
-----------------------------------------------------
Name | MEGAN SHEPHERD
-----------------------------------------------------
Credential | LPCC
-----------------------------------------------------
Telephone | 513-394-9864
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------