Provider Demographics
NPI:1184973125
Name:SHEPARD, LAURA PILLETTE (LCSW)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:PILLETTE
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 GODWIN AVE
Mailing Address - Street 2:STE. A
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-3149
Mailing Address - Country:US
Mailing Address - Phone:910-739-8849
Mailing Address - Fax:910-739-8698
Practice Address - Street 1:2003 GODWIN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3149
Practice Address - Country:US
Practice Address - Phone:910-739-8849
Practice Address - Fax:910-739-8698
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0086581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical