Debra Shepard, LCSW, RDDP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.016627 Issued in IL

Practice address

2601 W. Marquette Rd.
Catholic Charities
Chicago, IL 60629

Phone

(773) 349-8052

NPI assigned

Feb 13, 2017

Sex

Female

Sole proprietor

No

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

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.

• Brightland Health LLC

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1952815656
  NPD (past)

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1477092328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 W. MARQUETTE RD.",
            "address_2": "CATHOLIC CHARITIES",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629",
            "telephone_number": "773-349-8052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 W. MARQUETTE RD.",
            "address_2": "CATHOLIC CHARITIES",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629",
            "telephone_number": "773-349-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "DEBRA",
        "credential": "LCSW, RDDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Sheneman, M.D.
• Alexander Xiaoren Sheng, MD
• Sudhakar Kateel Shenoy, MD, FAPA
• Swati Shenoy, MPT
• Vikram Vishnu Shenoy
• Frederick Cary Shepard, LPC
• Janice Tucker Shepard, MS,CCC,SLP -L
• Kirk Van Shepard II, MD, MS
• Myrtise Shepard
• Rebekah S. Shephard, APRN

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 Feb 13, 2017; 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.