Individual
MR. CALEB JOHN SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890001177
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089-0001177
LICSW
VT
01
—
110290
LICSW
MA
Enumeration date
01/02/2007
Last updated
01/12/2023
Update your record
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