Provider Demographics
NPI:1235215781
Name:SHAFFER, ANNE CHILLINGWORTH (LSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:CHILLINGWORTH
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HIDDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2685
Mailing Address - Country:US
Mailing Address - Phone:724-941-4070
Mailing Address - Fax:724-941-5083
Practice Address - Street 1:1164 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-1014
Practice Address - Country:US
Practice Address - Phone:724-258-8014
Practice Address - Fax:724-258-8914
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW122641104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA19808020001Medicaid