Active NPI
Pamela R Shepp
- Professional Counselor
- Frederick, MD
National Provider Identifier
1104220664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC5791
- Practice address
- 116 Record St
Frederick, MD 21701-5418 - Phone
- (301) 620-8700
- Fax
- (301) 620-8710
- NPI assigned
- Oct 13, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LC5791 | MD | |
| Professional Counselor | 101YP2500X | LC5791 | MD | Primary |
Addresses
Primary practice location
116 Record St
Frederick, MD 21701-5418
Mailing address
116 Record St
Frederick, MD 21701-5418
Phone (301) 620-8700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5300 Westview Dr
Suite 301
Frederick, MD 21703-8374
Phone (301) 620-8700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC5791 | MD | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vital Sources, LLC | Professional | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Frederick, MD
- NPI 1669257218
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467676800000",
"number": "1104220664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 RECORD ST",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217015418",
"telephone_number": "301-620-8700",
"fax_number": "301-620-8710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 RECORD ST",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217015418",
"telephone_number": "301-620-8700",
"fax_number": "301-620-8710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPP",
"first_name": "PAMELA",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-13",
"last_updated": "2016-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "LC5791",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC5791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Frederick, MD
- Lonna Margaret Shelton-Soward, LGPC
- Lucy Shen
- Douglas W Shepard
- Rachael Shepherd
- Shepherd's Staff in-Home Care L.L.C.
- Melissa Sheppard, LCSW-C
- Katie Sheranko
- Sherman Kahan, MD, PA (Cardiology Associates of Frederick)
- Sherman Kahan, MD, PA (Cardiology Associates of Frederick)
- Harvey I. Sherman, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.