Carole Shepherd

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

069248 Issued in NY

Practice address

252 E 61St St
New York, NY 10021-8558

Phone

(212) 888-1430

NPI assigned

Sep 21, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Carole Shepherd-Radensky Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 30, 2016 through Sep 30, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Carole Shepherd

  • Clinical Social Worker
  • New York, NY
  • NPI 1184822843
  NPD (past)

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164418570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 E 61ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100218558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 E 61ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100218558",
            "telephone_number": "212-888-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "CAROLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLE",
            "last_name": "SHEPHERD-RADENSKY",
            "credential": "LCSW, LMT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Richard Joshua Shepard, DO
• Shakai Shepard, LAC
• Tiffany C Shepard, LPN
• Dia Shepardson, CM, LM
• Yuriy Shepelyak, M.D.
• Cassandra Shepherd, PA-C
• Chelsea Shiraz Shepherd, LCSW
• Fiona Marie Alice Shepherd, LCSW
• Gillian Mary Shepherd, M.D.
• Haley Shepherd, DPT, PT

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.