MRS. DEMETRIOUS THOMAS SHEPARD LPC NPI 1477618098

NPI Information

NPI: 1477618098
Provider Name: MRS. DEMETRIOUS THOMAS SHEPARD, LPC
Classification: Counselor - 101YP2500X
Specialization: Professional
Entity Type: Individual
Address: 824 GUM BRANCH RD STE E
JACKSONVILLE, NC
ZIP 28540
Phone: (910) 327-1694

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NPI Details

MRS. Demetrious Thomas Shepard, LPC is a professional counselor in Jacksonville, NC. MRS. Demetrious Thomas Shepard, LPC NPI is 1477618098. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

824 GUM BRANCH RD STE E
JACKSONVILLE, NC
ZIP 28540-270
Phone: (910) 327-1694
Fax: (910) 347-3694

The enumeration date for this NPI number is 12/26/2006 and was last updated on 7/31/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	4611	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6102002	MEDICAID	NORTH CAROLINA
2	1378X	OTHER	NORTH CAROLINA	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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