Individual provider Active NPI

Julie Michelle Sheppard, LCSW

  • Clinical Social Worker
  • Burleson, TX
National Provider Identifier
1710905591
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22292 Issued in TX
Practice address
2720 Park PL
Burleson, TX 76028-6324
Phone
(817) 675-7087
Fax
(817) 877-3562
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22292 TX Primary

Addresses

Primary practice location

2720 Park PL
Burleson, TX 76028-6324

Mailing address

2720 Park PL
Burleson, TX 76028-6324
Phone (817) 810-0030

Other identifiers 1

IdentifierTypeStateIssuer
063894201MedicaidTX

Other names 1

  • Miss Julie Michelle Anderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20040810001240 TX Practitioner - Clinical Social Worker 6608848627 Practice locations: Fort Worth, TX; Keene, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1314 Lake St
Suite 102
Fort Worth, TX 76102-4582
Phone (817) 675-7087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22292TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Mental Health Solutions, LP Clinical PastSince Jan 8, 2010 Accepting new patients
Associates in Psychiatry & Counseling, P.a. Clinical Past Accepting new patients
Stewart Keller DO PA Past Accepting new patients
Geriatric Mental Health Specialists, Inc. Clinical Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1710905591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 PARK PL",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760286324",
            "telephone_number": "817-810-0030",
            "fax_number": "817-293-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 PARK PL",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760286324",
            "telephone_number": "817-675-7087",
            "fax_number": "817-877-3562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "JULIE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "22292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063894201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "ANDERSON",
            "middle_name": "MICHELLE",
            "prefix": "MISS",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.