Provider Demographics
NPI:1043706419
Name:SHEPLEY, JESSICA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:SHEPLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 FOX HILL RD
Mailing Address - Street 2:
Mailing Address - City:BERNARDSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01337-9586
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:72 FOX HILL RD
Practice Address - Street 2:
Practice Address - City:BERNARDSTON
Practice Address - State:MA
Practice Address - Zip Code:01337-9586
Practice Address - Country:US
Practice Address - Phone:413-441-7079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10290103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent