Active NPI
Carl John Sheperis, LPC
- Mental Health Counselor
- Beaumont, TX
National Provider Identifier
1518358134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 72681
- Practice address
- 4400 MLK Jr. Pkwy
Lamar University, 115 Education Building
Beaumont, TX 77710-0034 - Phone
- (409) 880-7954
- Fax
- (409) 880-2263
- NPI assigned
- Feb 18, 2015
- Last updated
- Feb 18, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 72681 | TX | Primary |
Addresses
Primary practice location
4400 MLK Jr. Pkwy
Lamar University, 115 Education Building
Beaumont, TX 77710-0034
Mailing address
PO Box 10034
Lamar University, 105 Education Building
Beaumont, TX 77710-0034
Phone (409) 880-7954
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72681 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424217600000",
"number": "1518358134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10034",
"address_2": "LAMAR UNIVERSITY, 105 EDUCATION BUILDING",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777100034",
"telephone_number": "409-880-7954",
"fax_number": "409-880-2263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 MLK JR. PKWY",
"address_2": "LAMAR UNIVERSITY, 115 EDUCATION BUILDING",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777100034",
"telephone_number": "409-880-7954",
"fax_number": "409-880-2263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPERIS",
"first_name": "CARL",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-02-18",
"last_updated": "2015-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "72681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.