Alix Geneva Shepherd

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4093-57 Issued in WI

Practice address

316 N Milwaukee St Ste 401
Milwaukee, WI 53202-5925

Phone

(414) 758-8395

NPI assigned

Apr 24, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pacific University

  • Adult Mental Health Clinic/Center
  • Hillsboro, OR
  • NPI 1700256989
  NPD (past)

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

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1467987859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 N MILWAUKEE ST STE 401",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532025925",
            "telephone_number": "414-758-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 N MILWAUKEE ST STE 401",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532025925",
            "telephone_number": "414-758-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "ALIX",
        "middle_name": "GENEVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-24",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "4093-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shema Buda Home Care
• Jinnan Shen, RPH
• Gloria Shenkir, MD
• Samuel Joseph Shepard, PH.D.
• Therese Shepard, RN, BSN, CSN
• John Francis Shepherd III
• Nathan Sheppard
• Eileen C Sherburne, MSN, FNP, CNS
• Hammam Hussien Hakim Shereef, MD
• Alyssa R Sherer, PT

• Clinical Psychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.