| Lisa S. Shepard, LLC | |
|
16413 Howard Dr Macomb MI 48042-5783 | |
| (586) 260-4116 | |
| Not Available |
| Full Name | Lisa S. Shepard, LLC |
|---|---|
| Speciality | Counselor |
| Location | 16413 Howard Dr, Macomb, Michigan |
| Authorized Official Name and Position | Lisa S Shepard (PROFESSIONAL COUNSELOR/OWNER) |
| Authorized Official Contact | 5862604116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa S. Shepard, LLC 16413 Howard Dr Macomb MI 48042-5783 Ph: (586) 260-4116 | Lisa S. Shepard, LLC 16413 Howard Dr Macomb MI 48042-5783 Ph: (586) 260-4116 |
| NPI Number | 1124790290 |
|---|---|
| Provider Enumeration Date | 09/28/2021 |
| Last Update Date | 09/28/2021 |
| Certification Date | 09/28/2021 |
| Medicare PECOS PAC ID | 2264959584 |
|---|---|
| Medicare Enrollment ID | O20250509000095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124790290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (NU) | Primary |
| Provider Name | Lisa S Shepard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932493251 PECOS PAC ID: 3173040490 Enrollment ID: I20250609002950 |
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