Shelly Shepherd, | |
3221 Reynolds St, Laramie, WY 82072-5077 | |
(307) 703-0206 | |
Not Available |
Full Name | Shelly Shepherd |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 3221 Reynolds St, Laramie, Wyoming |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396197638 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | LPC-1135 (Wyoming) | Primary |
225X00000X | Occupational Therapist | 042 (Wyoming) | Secondary |
Entity Name | Pathway Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1588765069 PECOS PAC ID: 1254348626 Enrollment ID: O20060309000108 |
Mailing Address | Practice Location Address |
---|---|
Shelly Shepherd, 3321 Reynolds St, Laramie, WY 82072-5094 Ph: (307) 703-0206 | Shelly Shepherd, 3221 Reynolds St, Laramie, WY 82072-5077 Ph: (307) 703-0206 |
Jacquelyn Ralph, PPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1575 N 4th St Ste 103, Laramie, WY 82072 Phone: 307-721-0700 | |
Gail Ford, PPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1263 N 15th St, Laramie, WY 82072 Phone: 307-745-8915 | |
Karen Brooke Glahn, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 716 Mitchell St, Laramie, WY 82072 Phone: 801-400-4409 | |
Lois Kline, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1277 N 15th St, Laramie, WY 82072 Phone: 307-742-2181 | |
Samantha S Cowper, MA PPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1263 N 15th St, Laramie, WY 82072 Phone: 307-745-8915 Fax: 307-745-8761 | |
Jenna Hepp, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1575 N 4th St Ste 103, Laramie, WY 82072 Phone: 307-721-0700 | |
Brittany Bares, M.ED, PPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 217 E Grand Ave, Laramie, WY 82070 Phone: 419-494-3204 |