Provider Demographics
NPI:1013264902
Name:SHEPHERD, RHONDA L (LCSWA, LCAS, CCS)
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:L
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:LCSWA, LCAS, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4948 GERMANTON RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27105-2221
Mailing Address - Country:US
Mailing Address - Phone:336-972-9947
Mailing Address - Fax:336-725-1061
Practice Address - Street 1:1400 OLD MILL CIR STE A
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2977
Practice Address - Country:US
Practice Address - Phone:336-893-7742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP018825101Y00000X
NCLCAS-2859101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor