# ETHAN CHRISTOPHER SHEPHERD

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1871236687
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | CDCA.179916 | OH | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | CDCA.184392 | OH | Yes |
| 101YM0800X | Mental Health Counselor | APS.003292 | OH | — |
| 101YM0800X | Mental Health Counselor | QMHS | OH | — |

## Other

- **Enumeration date:** 04/19/2022
- **Last updated:** 03/16/2026