Provider Demographics
NPI:1043893423
Name:SHEPARD, SARAH ABBEY (CPRS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ABBEY
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 W MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3014
Mailing Address - Country:US
Mailing Address - Phone:740-277-7512
Mailing Address - Fax:
Practice Address - Street 1:121 W MULBERRY ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3014
Practice Address - Country:US
Practice Address - Phone:740-277-7512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0002653175T00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator