Provider Demographics
NPI:1194229476
Name:SHEPARD, LEANNE MARIE (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:LEANNE
Middle Name:MARIE
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 COUNTY ROAD 1450
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:TX
Mailing Address - Zip Code:76431-2905
Mailing Address - Country:US
Mailing Address - Phone:940-210-1946
Mailing Address - Fax:
Practice Address - Street 1:535 COUNTY ROAD 1450
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:TX
Practice Address - Zip Code:76431-2905
Practice Address - Country:US
Practice Address - Phone:940-210-1946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75490101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor