Provider Demographics
NPI:1881893568
Name:SHEPPARD, HEATHER GAZJUK (LPC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:GAZJUK
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9607 GARLAND CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6525
Mailing Address - Country:US
Mailing Address - Phone:704-779-7812
Mailing Address - Fax:704-341-6128
Practice Address - Street 1:10720 CARMEL COMMONS BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3785
Practice Address - Country:US
Practice Address - Phone:704-779-7812
Practice Address - Fax:704-341-6128
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5519101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional