Kevin Shepherd, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.017708 Issued in IL

Practice address

2012 E Amber LN
Apartment 206
Urbana, IL 61802-6971

Phone

(217) 474-2928

NPI assigned

Oct 5, 2015

Sex

Male

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

Enrolled in IL

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

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kshep Counseling PLLC

  • Clinical Social Worker
  • Champaign, IL
  • NPI 1205709938
  Medicare reassignment NPD Authorized official
• Keri Powell Therapy Inc

  dba Keri Powell Therapy

  • Mental Health Counselor
  • Champaign, IL
  • NPI 1174751663

  Clinical

  Medicare reassignment NPD
• Kevin Elliott Counseling PC

  • Mental Health Counselor
  • Urbana, IL
  • NPI 1255357422
  Medicare reassignment

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1962872739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 E AMBER LN",
            "address_2": "APARTMENT 206",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618026971",
            "telephone_number": "217-474-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 E AMBER LN",
            "address_2": "APARTMENT 206",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618026971",
            "telephone_number": "217-474-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya Lea Shaw, COTA/L
• Kathleen A. Shea
• Tim Shea, L.C.S.W.
• Shemauger Emergency Physicians LLC
• James L Shepherd, MD
• Maulik B Sheth, M.D.
• Bart Randall Shields, CRNA
• Noemi L Shilts, NP
• Sara Shipley, CADC
• Ashwin Ballupet Shivakumar, MD. MS

• Clinical Social Worker in Urbana, IL
• Providers in Urbana, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.