Reva Jo Sheppard, L.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

67149 Issued in TX

Practice address

1533 Merrimac Cir
Suite 101
Fort Worth, TX 76107-6506

Phone

(817) 810-0030

Fax

(817) 877-3562

NPI assigned

Sep 14, 2012

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

Medicare fee-for-service enrollment

Enrolled in TX

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1396095469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 MERRIMAC CIR",
            "address_2": "SUITE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076506",
            "telephone_number": "817-810-0030",
            "fax_number": "817-877-3562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 MERRIMAC CIR",
            "address_2": "SUITE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076506",
            "telephone_number": "817-810-0030",
            "fax_number": "817-877-3562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "REVA",
        "middle_name": "JO",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody Joy Shepherd Valley, EDD, CCC-SLP
• Jessica Blair Shepherd, MD
• Kendra Shepherd
• Amy Sheppard, CRNA
• Kimberly Lynn Sheppard, LCSW
• Richard K Sheppard, CRNA
• Khalda Shere, M.D., M.P.H.
• Elizabeth M Sherman, MSW
• Pamela J Sherman, MD
• Isabelle Madelaine Shero

• Professional Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.