Provider Demographics
NPI:1073637294
Name:SHAFFER, ILDIKO A (LPC)
Entity Type:Individual
Prefix:MS
First Name:ILDIKO
Middle Name:A
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9157 COLLINGTON SQ
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-1905
Mailing Address - Country:US
Mailing Address - Phone:724-679-4599
Mailing Address - Fax:
Practice Address - Street 1:4284 WILLIAM FLYNN HWY STE 209
Practice Address - Street 2:
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-1440
Practice Address - Country:US
Practice Address - Phone:724-679-4599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003494101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1696457OtherHIGHMARK BLUE SHIELD