Provider Demographics
NPI:1033319926
Name:SHAFAR, SHIRLEY (MA,NCC,LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:
Last Name:SHAFAR
Suffix:
Gender:F
Credentials:MA,NCC,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 W. CO AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904
Mailing Address - Country:US
Mailing Address - Phone:719-761-0746
Mailing Address - Fax:
Practice Address - Street 1:2021 W COLORADO AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-3840
Practice Address - Country:US
Practice Address - Phone:719-761-0746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4316101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional