Individual
KIRK SHEPPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39001804A
IN
101YP2500X
Professional Counselor
Primary
E.0700338-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000492477
BLUE SHIELD
IN
Enumeration date
01/22/2007
Last updated
10/02/2025
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