Individual provider Active NPI

Pamela R Shepp

  • Professional Counselor
  • Frederick, MD
National Provider Identifier
1104220664
Registry record updated Jul 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC5791 Issued in MD
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

Updated by the provider on Jul 5, 2016

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240111002282 MD Practitioner - Mental Health Counselor 2062828213 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
LC5791MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Vital Sources, LLC Professional PastSince Aug 19, 2013 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.

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

Sources for this page

Verify at the official NPI Registry.