Organization Active NPI

Sheppard Counseling LLC

  • Professional Counselor
  • Camdenton, MO
National Provider Identifier
1124870126
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
SHEPPARD COUNSELING LLC
Practice address
87 Sorrento Dr
Camdenton, MO 65020-4759
Phone
(573) 932-4676
Fax
(573) 515-1037
NPI assigned
Apr 3, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Authorized official

Name
Kristin E Albertin
Title
Office Admin
Phone
(573) 932-4676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

87 Sorrento Dr
Camdenton, MO 65020-4759

Mailing address

252 Lone Wolf Dr
Gravois Mills, MO 65037-6631
Phone (636) 388-3521

Other names 1

  • Sheppard Counseling LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240509002053 MO Part B Supplier - Clinic/Group Practice 2668813585 Receives reassigned benefits from 2 practitioners
Practice locations: Gravois Mills, MO

National Provider Directory

National Provider Directory

Locations

87 Sorrento Dr
Camdenton, MO 65020
Phone (573) 932-4676

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1124870126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 LONE WOLF DR",
            "city": "GRAVOIS MILLS",
            "state": "MO",
            "postal_code": "650376631",
            "telephone_number": "636-388-3521",
            "fax_number": "573-515-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 SORRENTO DR",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "650204759",
            "telephone_number": "573-932-4676",
            "fax_number": "573-515-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPPARD COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "ALBERTIN",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE ADMIN",
        "authorized_official_telephone_number": "573-932-4676"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sheppard Counseling LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camdenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.