Provider Demographics
NPI:1902209430
Name:SHEPARD, EVA (MLADC/LCMHC)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:MLADC/LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 JAFFREY RD
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03455-2517
Mailing Address - Country:US
Mailing Address - Phone:603-213-0882
Mailing Address - Fax:603-217-3892
Practice Address - Street 1:143 JAFFREY RD
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03455-2517
Practice Address - Country:US
Practice Address - Phone:603-213-0882
Practice Address - Fax:603-217-3892
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NH4969101YM0800X
NH1549101YP2500X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional