Individual provider Active NPI

Susan Elizabeth Sheppard, LMHC

  • Mental Health Counselor
  • Winter Park, FL
National Provider Identifier
1275651440
Registry record updated Jan 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3806 Issued in FL
Practice address
2802 Aloma Ave Ste 102
Winter Park, FL 32792-3532
Phone
(407) 415-0206
Fax
(407) 628-3300
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3806 FL Primary

Addresses

Primary practice location

2802 Aloma Ave Ste 102
Winter Park, FL 32792-3532

Mailing address

2802 Aloma Ave Ste 102
Winter Park, FL 32792-3532
Phone (407) 415-0206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240209002186 FL Practitioner - Mental Health Counselor 4284087636 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3806FLMDVeterinarian

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Relationship Development Inc Mental Health CurrentSince Jan 29, 2024 Accepting new patients

Locations

2802 Aloma Ave
Ste 102
Winter Park, FL 32792
Phone (321) 765-3855

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200787200000",
    "number": "1275651440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 ALOMA AVE STE 102",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923532",
            "telephone_number": "407-415-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 ALOMA AVE STE 102",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923532",
            "telephone_number": "407-415-0206",
            "fax_number": "407-628-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "3806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.