Provider Demographics
NPI:1093134876
Name:SHEPELEW, NAMHEE
Entity Type:Individual
Prefix:MRS
First Name:NAMHEE
Middle Name:
Last Name:SHEPELEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 INDEPENDENCE BLVD
Mailing Address - Street 2:SUIT 100
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-2135
Mailing Address - Country:US
Mailing Address - Phone:941-359-1927
Mailing Address - Fax:
Practice Address - Street 1:1500 INDEPENDENCE BLVD
Practice Address - Street 2:SUIT 100
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-2135
Practice Address - Country:US
Practice Address - Phone:941-359-1927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 10562101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor