Provider Demographics
NPI:1619103967
Name:ALDERMAN, NANCY SHEPPARD (LCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:SHEPPARD
Last Name:ALDERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:DILL
Other - Last Name:SHEPPARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:202 N. MT. RUSHMORE DR.
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613
Mailing Address - Country:US
Mailing Address - Phone:512-577-5998
Mailing Address - Fax:512-485-2432
Practice Address - Street 1:13625 POND SPRINGS RD
Practice Address - Street 2:SUITE 106
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729
Practice Address - Country:US
Practice Address - Phone:512-577-5998
Practice Address - Fax:512-485-2432
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201111041C0700X
GA201111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB135527Medicaid