Provider Demographics
NPI:1962203414
Name:SHEPPARD, ZOEY NIKOLE
Entity type:Individual
Prefix:
First Name:ZOEY
Middle Name:NIKOLE
Last Name:SHEPPARD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 GREENLEAF ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-2349
Mailing Address - Country:US
Mailing Address - Phone:903-445-2376
Mailing Address - Fax:
Practice Address - Street 1:1709 GREENLEAF ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-2349
Practice Address - Country:US
Practice Address - Phone:903-445-2376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical