Active NPI
Tisha Shepherd
- Addiction (Substance Use Disorder) Counselor
- Greenville, OH
National Provider Identifier
1760939896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.160820
- Practice address
- 600 Walnut St.
Greenville, OH 45331 - Phone
- (937) 335-0361
- Fax
- (937) 339-7816
- NPI assigned
- Sep 7, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.160820 | OH | Primary |
Addresses
Primary practice location
600 Walnut St.
Greenville, OH 45331
Mailing address
719 E 3Rd St
Greenville, OH 45331
Phone (937) 467-8055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.160820 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473206400000",
"number": "1760939896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 E 3RD ST",
"city": "GREENVILLE",
"state": "OH",
"postal_code": "45331",
"telephone_number": "937-467-8055",
"fax_number": "937-339-7816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 WALNUT ST.",
"city": "GREENVILLE",
"state": "OH",
"postal_code": "45331",
"telephone_number": "937-335-0361",
"fax_number": "937-339-7816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "TISHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-07",
"last_updated": "2016-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.160820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.