Individual
LACEY RACHELLE SHEPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1806 W LINCOLN AVE, YAKIMA, WA 98902-2473
(509) 452-4520
(509) 452-5224
Mailing address
501 S 5TH AVE, YAKIMA, WA 98902-3550
(509) 853-1082
(509) 452-5224
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW60317451
WA
1041C0700X
Clinical Social Worker
L5203
OR
1041C0700X
Clinical Social Worker
LW60317451
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0479545
L&I
WA
05
—
2271294
—
WA
05
—
500645125
—
OR
Enumeration date
07/18/2008
Last updated
02/04/2025
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