Provider Demographics
NPI:1336294065
Name:SHEPHERD, JULIE HENDERSON (LMSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:HENDERSON
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304A N MORNINGSIDE DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3368
Mailing Address - Country:US
Mailing Address - Phone:404-875-7678
Mailing Address - Fax:
Practice Address - Street 1:776 WINDSOR PKWY NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-2849
Practice Address - Country:US
Practice Address - Phone:404-303-7247
Practice Address - Fax:404-303-7837
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW004128101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor