Bryan Shepard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34008606A Issued in IN

Practice address

520 S Walnut St
Bloomington, IN 47401-4618

Phone

(812) 502-4100

Fax

(812) 502-4200

NPI assigned

Aug 6, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Dauntless Counseling and Consulting LLC

  • Clinical Social Worker
  • Bloomington, IN
  • NPI 1316694375
  NPD Authorized official

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1366828865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S WALNUT ST # 3126",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474014618",
            "telephone_number": "812-502-4100",
            "fax_number": "812-502-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S WALNUT ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474014618",
            "telephone_number": "812-502-4100",
            "fax_number": "812-502-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "BRYAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-06",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008606A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Sheikh, LCSW
• Jenna Shelby, RBT, BS
• Christian Shelton
• Mohan Shenoy, M.D.
• Shruti Shenoy
• Catherine Shepherd, MS, RD, CD
• Sage Sherfick, RBT
• Sheridan Emergency Physician Services of Indiana, PC
• Roberta Sherman, PH.D.
• Erin L Sherrill

• Clinical Social Worker in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.