Jennifer Shepherd, L.C.S.W

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW2492 Issued in AZ

Practice address

14780 W Mountain View Blvd Ste 110
Surprise, AZ 85374-7280

Phone

(623) 374-7774

Fax

(855) 420-6361

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1952519795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 E DOLPHIN CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062229",
            "telephone_number": "480-854-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14780 W MOUNTAIN VIEW BLVD STE 110",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747280",
            "telephone_number": "623-374-7774",
            "fax_number": "855-420-6361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 E Rivulon Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852970008",
            "country_code": "US",
            "telephone_number": "602-734-5664",
            "fax_number": "480-401-3844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6344 E Broadway Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852061634",
            "country_code": "US",
            "telephone_number": "480-703-1894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW2492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Raylene Short

• Clinical Social Worker in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.