Provider Demographics
NPI:1396038675
Name:SHAFFER, DEBRA L (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:L
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:APOLLO
Mailing Address - State:PA
Mailing Address - Zip Code:15613-9249
Mailing Address - Country:US
Mailing Address - Phone:814-233-0536
Mailing Address - Fax:
Practice Address - Street 1:4326 NORTHERN PIKE STE 202
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2838
Practice Address - Country:US
Practice Address - Phone:412-373-7173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical