Provider Demographics
NPI:1629829965
Name:SHEPHARD, HOLLY D (LCMHC)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:D
Last Name:SHEPHARD
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:D
Other - Last Name:STRIPPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05601-0647
Mailing Address - Country:US
Mailing Address - Phone:802-229-0591
Mailing Address - Fax:802-223-3667
Practice Address - Street 1:286 HOSPITAL LOOP
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9523
Practice Address - Country:US
Practice Address - Phone:802-229-0591
Practice Address - Fax:802-223-3667
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0135813101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health