Provider Demographics
NPI:1467547273
Name:GAFFNEY, DAVID EDWARD (MSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:EDWARD
Last Name:GAFFNEY
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3302 DELEVAN DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-1734
Mailing Address - Country:US
Mailing Address - Phone:989-980-1233
Mailing Address - Fax:
Practice Address - Street 1:5090 STATE ST STE B103
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603
Practice Address - Country:US
Practice Address - Phone:989-980-1233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010576601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI750910806OtherBCBS IDENTIFYER
MI0991234OtherHEALTHPLUS PROVIDER ID
MI386004889OtherHEALTHSOURCE EMPLOYER ID