Individual provider Active NPI

Julia Sheppard, LCSW

  • Clinical Social Worker
  • Clinton, OK
National Provider Identifier
1508051053
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2376 Issued in OK
Practice address
3203 S Highway 183 Lot 23
Clinton, OK 73601-9602
Phone
(580) 649-1100
NPI assigned
Sep 7, 2007
Last updated
Aug 27, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2376 OK Primary

Addresses

Primary practice location

3203 S Highway 183 Lot 23
Clinton, OK 73601-9602

Mailing address

PO Box 174
Clinton, OK 73601-0174
Phone (580) 649-1100

Other identifiers 3

IdentifierTypeStateIssuer
12194777OtherOKCAQH
2376OtherOKLCSW
33781OtherOKCERTIFIED REHABILITATION COUNSELOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20071219000363 OK Practitioner - Clinical Social Worker 0042300675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oklahoma Mental Health CouncilGroup PAC ID 3173514387, 69 clinicians

Practice addresses (Care Compare)

4130 N Lincoln Blvd
Red Rock Behavioral Health Services
Oklahoma City, OK 73105-5209
Phone (405) 424-7711

4400 N Lincoln Blvd
Oklahoma City, OK 73105-5104

4420 N Lincon Blvd
Red Rock Behavioral
Oklahoma City, OK 73105-5104
Phone (405) 424-7711

Merit-based Incentive Payment System (MIPS)

Final score
72.37 of 100Reported as group
Quality
54.6
Improvement activities
40
Cost
74.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2376OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Mental Health Council CurrentSince Oct 27, 2013 Accepting new patients
Oklahoma Mental Health Council CurrentSince Oct 27, 2013 Accepting new patients
Fortis Therapy LLC Past Accepting new patients

Locations

4400 N Lincoln Blvd
Oklahoma City, OK 73105

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1508051053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 174",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736010174",
            "telephone_number": "580-649-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3203 S HIGHWAY 183 LOT 23",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736019602",
            "telephone_number": "580-649-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "JULIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "2376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12194777",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "2376",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED REHABILITATION COUNSELOR",
            "identifier": "33781",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, OK

Sources for this page

Verify at the official NPI Registry.