Provider Demographics
NPI:1942744016
Name:SHEPARD, JAMES COLLIER (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:COLLIER
Last Name:SHEPARD
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 163333
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32816-3333
Mailing Address - Country:US
Mailing Address - Phone:407-823-2701
Mailing Address - Fax:
Practice Address - Street 1:4098 LIBRA DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32816-3333
Practice Address - Country:US
Practice Address - Phone:407-823-2701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16588101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health