Sandra Jo Shepard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.006734 Issued in IL

Practice address

306 Gazebo LN
Lombard, IL 60148-7119

Phone

(630) 310-6650

NPI assigned

Jan 23, 2020

Last updated

Jan 23, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1427688084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 GAZEBO LN",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601487119",
            "telephone_number": "630-310-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 GAZEBO LN",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601487119",
            "telephone_number": "630-310-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "SANDRA",
        "middle_name": "JO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.006734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahfouza Mustafa Shatat
• Renee A Shea, LMFT, CADC
• Shaheen Shedbalker
• Katrina Shelby
• Jialu Shen
• Edward Sherman, MD
• Rajit Shetty, MD
• Shifa Therapeutics LLC
• Samir Shimi
• Julie Shuert, CCC SLP

• Clinical Social Worker in Lombard, IL
• Providers in Lombard, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.