Provider Demographics
NPI:1659727352
Name:SHEPHERD, KATHLEEN (MSW)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 N VEITCH ST
Mailing Address - Street 2:1813
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-6221
Mailing Address - Country:US
Mailing Address - Phone:703-475-1727
Mailing Address - Fax:
Practice Address - Street 1:1320 N VEITCH ST
Practice Address - Street 2:1813
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-6221
Practice Address - Country:US
Practice Address - Phone:703-475-1727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical