Individual provider Active NPI

Shane Christopher Shepperd, LCMHC

  • Mental Health Counselor
  • Morrisville, VT
National Provider Identifier
1417674896
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
068.0135744 Issued in VT
Practice address
607 Washington Hwy
Morrisville, VT 05661-8652
Phone
(802) 888-8320
Fax
(802) 888-8136
NPI assigned
Oct 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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 068.0135744 VT Primary

Addresses

Primary practice location

607 Washington Hwy
Morrisville, VT 05661-8652

Mailing address

607 Washington Hwy
Morrisville, VT 05661-8652
Phone (802) 851-8619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20240307000752 VT Practitioner - Mental Health Counselor 8729424270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: shane.shepperd.p1@direct.chcb.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1417674896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 WASHINGTON HWY",
            "city": "MORRISVILLE",
            "state": "VT",
            "postal_code": "056618652",
            "telephone_number": "802-851-8619",
            "fax_number": "802-851-8716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 WASHINGTON HWY",
            "city": "MORRISVILLE",
            "state": "VT",
            "postal_code": "056618652",
            "telephone_number": "802-888-8320",
            "fax_number": "802-888-8136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPERD",
        "first_name": "SHANE",
        "middle_name": "CHRISTOPHER",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0135744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrisville, VT

Sources for this page

Verify at the official NPI Registry.