Glenn L Shephard Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005288 Issued in CT

Practice address

9 Mott Ave Ste 310
Norwalk, CT 06850-3916

Phone

(917) 608-1429

Fax

(203) 909-6483

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Clinical Social Worker

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1861608101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MOTT AVE STE 310",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068503337",
            "telephone_number": "917-608-1429",
            "fax_number": "203-909-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MOTT AVE STE 310",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068503916",
            "telephone_number": "917-608-1429",
            "fax_number": "203-909-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHARD",
        "first_name": "GLENN",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "040900-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmed Elsayed Mahmoud Shehata, MBBCH
• Shel Dental, P.C.
• Joanna Patricia Sheldon, DNP
• Amanda Shepard
• Lisa Shepard
• Cindy K Sherlock, M.S., R.D., CD-N
• Anupama Shetty, M.D.
• Sudhakar Shetty, MD
• Dennis Edward Shield, M.D.
• Andrew Chung-Ming Shih, M.D.

• Clinical Social Worker in Norwalk, CT
• Providers in Norwalk, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.