Provider Demographics
NPI:1376710830
Name:SHEPERIS, DONNA S (PHD LPC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:S
Last Name:SHEPERIS
Suffix:
Gender:F
Credentials:PHD LPC
Other - Prefix:DR
Other - First Name:DONNA
Other - Middle Name:S
Other - Last Name:STARKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD LPC
Mailing Address - Street 1:PO BOX 346
Mailing Address - Street 2:
Mailing Address - City:MERIGOLD
Mailing Address - State:MS
Mailing Address - Zip Code:38759-0346
Mailing Address - Country:US
Mailing Address - Phone:662-641-0435
Mailing Address - Fax:662-846-4549
Practice Address - Street 1:109 W SOUTH STREET MERIGOLD
Practice Address - Street 2:
Practice Address - City:MERIGOLD
Practice Address - State:MS
Practice Address - Zip Code:38759-0346
Practice Address - Country:US
Practice Address - Phone:662-641-0435
Practice Address - Fax:662-846-4549
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0352101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS$$$$$$$$$AOtherBLUE CROSS BLUE SHIELD MS