Individual provider Active NPI

Sirina Shepherd, MSW, LCSW

  • Clinical Social Worker
  • Waukesha, WI
National Provider Identifier
1154975423
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9982123 Issued in WI
Practice address
N14W23777 Stone Ridge Dr Ste 135
Waukesha, WI 53188-1164
Phone
(414) 446-0751
NPI assigned
Jul 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Social Worker 104100000X 131277-121 WI
Clinical Social Worker 1041C0700X 9982123 WI Primary

Addresses

Primary practice location

N14W23777 Stone Ridge Dr Ste 135
Waukesha, WI 53188-1164

Mailing address

N14W23777 Stone Ridge Dr Ste 135
Waukesha, WI 53188-1164
Phone (414) 446-0751

Other names 1

  • Sirina Raufman Former name

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

State licenses

LicenseStateTypeSpecialty
131277-121WIMDSocial Worker
9982123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerment Within LLC Mental Health CurrentSince Apr 16, 2023 Accepting new patients

Locations

N14W23777 Stone Ridge Dr
Ste 135
Waukesha, WI 53188
Phone (414) 279-9082

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": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1154975423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N14W23777 STONE RIDGE DR STE 135",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881164",
            "telephone_number": "414-446-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N14W23777 STONE RIDGE DR STE 135",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881164",
            "telephone_number": "414-446-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "SIRINA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "131277-121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9982123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIRINA",
            "last_name": "RAUFMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.