Provider Demographics
NPI:1043608326
Name:SHAFFER, JOSEPH (MS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SHAFFER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 4TH AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1430
Mailing Address - Country:US
Mailing Address - Phone:859-489-2705
Mailing Address - Fax:
Practice Address - Street 1:102 PATRICK STREET PLZ
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25387-2444
Practice Address - Country:US
Practice Address - Phone:859-489-2075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)