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Individual

JENNIFER A SHEPHERD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCC, LADC

Contact information

Practice address
3231 1ST AVE S, MINNEAPOLIS, MN 55408-4407
(612) 238-6525
Mailing address
3231 1ST AVE S, MINNEAPOLIS, MN 55408-4407
(612) 238-6525

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305275
MN
101YP2500X
Professional Counselor
Primary
CC01966
MN

Other

Enumeration date
03/05/2018
Last updated
02/22/2022
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