Rosalind Renee Sheppard, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

06296 Issued in MD

Practice address

2138 Priest Bridge CT Ste 1
Crofton, MD 21114-2463

Phone

(435) 846-7734

NPI assigned

Jan 28, 2021

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Essential Outcomes, LLC

  • Psychologist
  • Crofton, MD
  • NPI 1083285928
  NPD

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1508457979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 STATE ROUTE 3 N # 300",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541715",
            "telephone_number": "443-584-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2138 PRIEST BRIDGE CT STE 1",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142463",
            "telephone_number": "435-846-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "ROSALIND",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "06296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317165500",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "999378900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Ian Segal, LCSW-C
• Sarah Michel Seibold, PTA
• Karla Sellers, MS, CRNP
• Chantel Dominique Shaw
• Taci Shaw, MA.LDT
• Sherri Dibatttista
• Evette Shields
• Mark Ehren Shires, ATC
• Bailie Siddiqui, IBCLC
• Sightrite Medical MD LLC

• Psychologist in Crofton, MD
• Providers in Crofton, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.