Jeanetta Sheppard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2027C Issued in AL

Practice address

301 Andrews Avenue
United States Army Substance Abuse Program
Fort Rucker, AL 36362-5105

Phone

(334) 255-7918

Fax

(334) 255-7617

NPI assigned

Feb 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1689649857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ANDREWS AVE.",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "363625105",
            "telephone_number": "334-255-7918",
            "fax_number": "334-255-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ANDREWS AVENUE",
            "address_2": "UNITED STATES ARMY SUBSTANCE ABUSE PROGRAM",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "363625105",
            "telephone_number": "334-255-7918",
            "fax_number": "334-255-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "JEANETTA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "CAP867",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "ICADC6435",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7254",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "2027C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Michael Scott, EMT
• Sherri Lynn Senn, RN
• Cynthia Serna, LPN
• Sharla Denise Shafer, RN
• Cody Shedd, NREMT
• Patricia A. Sherman, LPN
• James Vincent Shields, NREMP
• George Shreffler, NREMT
• Kristina Siegrist, LPN
• Doris Trina' Sisk, LICSW

• Clinical Social Worker in Fort Rucker, AL
• Providers in Fort Rucker, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.