Provider Demographics
NPI:1104336452
Name:SHEPARD, ELISE NICOLE (LCSW)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:NICOLE
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELLIE
Other - Middle Name:NICOLE
Other - Last Name:SHEPARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:5910 S UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80121-2879
Mailing Address - Country:US
Mailing Address - Phone:800-275-8777
Mailing Address - Fax:
Practice Address - Street 1:7853 E ARAPAHOE CT STE 2700
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1361
Practice Address - Country:US
Practice Address - Phone:720-802-5314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-01
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099314831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical