MEDICARE: MRS. TONI ANN SHEPPARD LPC, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	656	LA
2	101YM0800X	Mental Health Counselor	2687	LA

General Provider Information

NPI Number	:	1306961701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TONI ANN SHEPPARD LPC, LMFT

Provider Business Mailing Address
First Line	:	2285 BENTON RD
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-7933
Country	:	US
Telephone Number	:	318-455-8995
Fax Number	:

Provider Business Practice Location Address
First Line	:	2285 BENTON RD
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-7933
Country	:	US
Telephone Number	:	318-455-8995
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	08/23/2019

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