Provider Demographics
NPI:1578894069
Name:SHEPPARD, RACHEL (LMSW)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:SHEPPARD
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 1:135 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-2912
Mailing Address - Country:US
Mailing Address - Phone:518-691-0732
Mailing Address - Fax:518-691-0732
Practice Address - Street 1:77 TARRYTOWN RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1639
Practice Address - Country:US
Practice Address - Phone:914-502-3998
Practice Address - Fax:914-502-3998
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0805351041C0700X
PASW128179104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker