Provider Demographics
NPI:1295496511
Name:SHEPHERD, MEGAN (LPCC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 ORCHARD RUN RD STE 341
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-2831
Mailing Address - Country:US
Mailing Address - Phone:937-503-7437
Mailing Address - Fax:
Practice Address - Street 1:1209 MOUNTAIN ROAD PL NE STE R
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7845
Practice Address - Country:US
Practice Address - Phone:575-741-6376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-08
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2404019101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health