Individual provider Active NPI

Danielle Elizabeth Shepherd, MS, LCMHC-A, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Nags Head, NC
National Provider Identifier
1033727714
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCAS-26348 Issued in NC
Practice address
2224 S Croatan Hwy
Nags Head, NC 27959-8813
Phone
(252) 715-6556
Fax
(252) 715-6558
NPI assigned
Jul 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A15904 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-26348 NC Primary

Addresses

Primary practice location

2224 S Croatan Hwy
Nags Head, NC 27959-8813

Mailing address

2019 Highview St
Kill Devil Hills, NC 27948-9325
Phone (301) 873-7018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LCAS-26348NCMDAddiction (Substance Use Disorder) Counselor
A15904NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
East Coast Counseling Inc Addiction (Substance Use Disorder) PastSince Jul 1, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1033727714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 HIGHVIEW ST",
            "city": "KILL DEVIL HILLS",
            "state": "NC",
            "postal_code": "279489325",
            "telephone_number": "301-873-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2224 S CROATAN HWY",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279598813",
            "telephone_number": "252-715-6556",
            "fax_number": "252-715-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "DANIELLE",
        "middle_name": "ELIZABETH",
        "credential": "MS, LCMHC-A, LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A15904",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-26348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nags Head, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.