Provider Demographics
NPI:1437115151
Name:SCHAFFER, DAVID M (CSW, MSW, LICSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:M
Last Name:SCHAFFER
Suffix:
Gender:M
Credentials:CSW, MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104
Mailing Address - Country:US
Mailing Address - Phone:304-865-0272
Mailing Address - Fax:304-865-0265
Practice Address - Street 1:3705 EMERSON AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-1118
Practice Address - Country:US
Practice Address - Phone:304-865-0272
Practice Address - Fax:304-865-0265
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.00091451041C0700X
WVDP009402111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVSW22493Medicare PIN
P09699Medicare UPIN