Myrdis Y. Sheppard, BA

Individual provider Active NPI Counselor · Edgefield, SC

NPI 1649338286 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1649338286
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
409 Simpkins St
Edgefield, SC 29824-1313
Phone
(803) 637-5338
Fax
(803) 637-0753
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Yes

Addresses

Primary practice location

409 Simpkins St
Edgefield, SC 29824-1313

Mailing address

1547 Parkway
Suite 100
Greenwood, SC 29646-4081
Phone (864) 229-7120

Other identifiers

IdentifierTypeStateIssuer
421504MedicaidSC

Other providers in Edgefield, SC

All providers in Edgefield, SC · Counselor in South Carolina

Sources for this page

Verify at the official NPI Registry.