Provider Demographics
NPI:1447621966
Name:SHEPLER PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:SHEPLER PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHEPLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LP
Authorized Official - Phone:419-303-9542
Mailing Address - Street 1:313 W LA SALLE AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-2556
Mailing Address - Country:US
Mailing Address - Phone:419-303-9542
Mailing Address - Fax:
Practice Address - Street 1:313 W LA SALLE AVE
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-2556
Practice Address - Country:US
Practice Address - Phone:419-303-9542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015402103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty