Haley Dyan Morgan Shepard, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC02297 Issued in MN

Practice address

14949 62ND St N
Stillwater, MN 55082-6132

Phone

(651) 430-8344

Fax

(651) 430-6527

NPI assigned

Jun 13, 2020

Last updated

Jun 13, 2020By the provider in NPPES

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

• Haley Dyan Shepard Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mentallurgy PLLCGroup PAC ID 2567835200, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Law

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mentallurgy, PLLC

  • Clinical Social Worker
  • Saint Paul, MN
  • NPI 1235855107
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1592006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592006400000",
    "number": "1255956496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14949 62ND ST N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826132",
            "telephone_number": "651-430-8344",
            "fax_number": "651-430-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14949 62ND ST N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826132",
            "telephone_number": "651-430-8344",
            "fax_number": "651-430-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN SHEPARD",
        "first_name": "HALEY",
        "middle_name": "DYAN",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-13",
        "last_updated": "2020-06-13",
        "certification_date": "2020-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC02297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "SHEPARD",
            "middle_name": "DYAN",
            "credential": "LPCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John F Moffatt, MA
• Abduljibbar Jama Mohammed
• Ann Marie Monson Slagle, PA-C
• Monte Norgaard MD PA
• Sandra Morelli, LADC
• Kelsey Rae Morinville, CRNA
• Carolyn Morris
• David Morris, PH.D.
• Lawrence Edward Morrissey Jr., MD
• Alicia Morth

• Mental Health Counselor in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2020; 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.

Verify at the official NPI Registry.