Shepard, Demetrious Thomas

Shepard, Demetrious Thomas is an individual health care provider with primary practice located at 824 Gum Branch Rd Ste E , Jacksonville NC 28540-6270. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Shepard, Demetrious Thomas can be contacted via phone (910) 327-1694.

Contact Information

Primary practice address
824 Gum Branch Rd Ste E Jacksonville NC 28540-6270
Phone: (910) 327-1694
Fax: (910) 347-3694
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 4611 North Carolina

Profile Details

NPI number 1477618098
LBN Legal business name Shepard, Demetrious Thomas
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 26th, 2006
Last updated Jul 31st, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477618098 NPPES
North Carolina Other 1378X BCBS
North Carolina MEDICAID 6102002 BCBS

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