Shepherd, Evan M

Shepherd, Evan M is an sole proprietor health care provider with primary practice located at 700 Park Ave , Ironton OH 45638-1502. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Shepherd, Evan M can be contacted via phone (740) 532-1613.

Contact Information

Primary practice address
700 Park Ave Ironton OH 45638-1502
Phone: (740) 532-1613
Fax: (740) 879-0599
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X C.2406620 Ohio
Behavioral Health & Social Service Providers / Mental Health 101YM0800X C.2305222-TRNE Ohio
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LICDC.162365 Ohio

Profile Details

NPI number 1861055071
LBN Legal business name Shepherd, Evan M
Credentials LICDC, LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 15th, 2019
Last updated Nov 7th, 2024 - about 2 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 1861055071 NPPES
Ohio MEDICAID 0368213

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