MEDICARE: JUDY SHEPPARD LCPC

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	101YP2500X	Professional Counselor	LC13303	MD
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAL2054	MD

General Provider Information

NPI Number	:	1356747026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY SHEPPARD LCPC

Provider Business Mailing Address
First Line	:	8865 STANFORD BLVD STE 200
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-5420
Country	:	US
Telephone Number	:	410-935-1821
Fax Number	:

Provider Business Practice Location Address
First Line	:	8865 STANFORD BLVD STE 200
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-5420
Country	:	US
Telephone Number	:	410-935-1821
Fax Number	:

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

Provider Enumeration Date	:	11/07/2014
Last Update Date	:	09/09/2025

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