Provider Demographics
NPI:1669793550
Name:SHEPARD, EMILY MCGEE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:MCGEE
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 ACME RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1544
Mailing Address - Country:US
Mailing Address - Phone:207-907-4677
Mailing Address - Fax:207-907-4677
Practice Address - Street 1:43 ACME RD
Practice Address - Street 2:SUITE A
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1544
Practice Address - Country:US
Practice Address - Phone:207-907-4677
Practice Address - Fax:207-907-4677
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC9757101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health