Provider Demographics
NPI:1225204597
Name:SCHAFFNER, MICHELE (LMHC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:SCHAFFNER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BURBANK DR
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-9485
Mailing Address - Country:US
Mailing Address - Phone:386-447-4847
Mailing Address - Fax:386-447-4847
Practice Address - Street 1:517 S RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-4929
Practice Address - Country:US
Practice Address - Phone:386-248-2771
Practice Address - Fax:386-248-2874
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 6519101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL761655400Medicaid