Cynthia L Shepherd, M.A., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Huntertown, IN
NPI 1689899486 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1689899486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 22004329A (IN)
- Practice address
- 2824 Hunter Rd
Huntertown, IN 46748-9456 - Phone
- (260) 338-0601
- Fax
- (260) 637-0968
- NPI assigned
- Apr 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fort Wayne Neuropsychology LLC
Practice addresses (Care Compare)
4306 E State Blvd
Fort Wayne, IN 46815-6915
Phone (260) 406-3203
PO Box
Suite 10268
Fort Wayne, IN 46851-0268
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200318000447 | IN | Practitioner - Qualified Speech Language Pathologist | 7416385885 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22004329A | IN | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 22004329A | IN | Yes |
Addresses
Primary practice location
2824 Hunter Rd
Huntertown, IN 46748-9456
Mailing address
2824 Hunter Rd
Huntertown, IN 46748-9456
Phone (260) 338-0601
Other providers in Huntertown, IN
- Kelsey Pence
- Perry Civiltownship Allen County Ttee
- Kaley Lynn Ponder
- Quality Behavioral Services, Inc.
- Ryan Rolf MD LLC
- Ella Christine Smith
- Thomas Paul Sodano
- Angela Suzanne Sorg
- Amy Lynn Spallinger
- Allison Vorndran
All providers in Huntertown, IN · Speech-Language Pathologist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.