Provider Demographics
NPI:1497182570
Name:SHEPARD, CHARLES (LPC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:SHEPARD
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2322 BLUE STONE HILLS DR
Mailing Address - Street 2:SUITE 280
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-5403
Mailing Address - Country:US
Mailing Address - Phone:540-437-1605
Mailing Address - Fax:540-437-1606
Practice Address - Street 1:2322 BLUE STONE HILLS DR
Practice Address - Street 2:SUITE 280
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-5403
Practice Address - Country:US
Practice Address - Phone:540-437-1605
Practice Address - Fax:540-437-1606
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005604101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional