Desmond L Shepherd, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3533 Issued in OK

Practice address

8104 S Quebec Ave
Tulsa, OK 74137-1849

Phone

(918) 764-9832

NPI assigned

Sep 24, 2009

Sex

Male

Sole proprietor

Yes

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

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

Specialty

Mental Health Counselor

Education

Other, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Positive Life Solutions Counseling LLC

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1730830340
  NPD Authorized official
• Resolve Behavioral Health Services

  • Clinical Social Worker
  • Tulsa, OK
  • NPI 1497232888
  Medicare reassignment

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1669706503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8104 S QUEBEC AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741371849",
            "telephone_number": "918-688-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8104 S QUEBEC AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741371849",
            "telephone_number": "918-764-9832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "DESMOND",
        "middle_name": "L",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-24",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "3533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neely J Shenloogian, D.C.
• Fysal Shennib, MD
• Benjamin Andrew Shepard, D.O.
• Rowland Shepard
• Shepcole, Inc.
• Kesha Devonne Shepherd, B.S.
• Larry T Shepherd, D.O.
• Leonard Shepherd, M.S.
• Mae Ann Shepherd, LPC, LADC
• Rachelle Shepherd, LMSW

• Professional Counselor in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.