Provider Demographics
NPI:1144423286
Name:SHAFFER, BARBARA W (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:W
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 222
Mailing Address - Street 2:
Mailing Address - City:MENDENHALL
Mailing Address - State:PA
Mailing Address - Zip Code:19357-0222
Mailing Address - Country:US
Mailing Address - Phone:610-388-2233
Mailing Address - Fax:610-388-2163
Practice Address - Street 1:512 KENNETT PIKE
Practice Address - Street 2:STE 100
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-7306
Practice Address - Country:US
Practice Address - Phone:610-388-2233
Practice Address - Fax:610-388-2163
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAP-005890-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASH673788Medicare PIN