Individual
MR. ADDIS LEE SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
THERAPIST
Contact information
Practice address
THE COMMITMENT HOUSE, 115 PARKWAY DRIVE, ELIZABETHTOWN, KY 42701-7827
(270) 900-0373
Mailing address
902 WINCHESTER BLVD, ELIZABETHTOWN, KY 42701-9167
(270) 325-1027
(270) 765-2557
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
275079
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
$$$$$$$$$
—
KY
Enumeration date
09/11/2018
Last updated
01/08/2024
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