Provider Demographics
NPI:1467748699
Name:SCHIFFHAUER, JASON ALAN (LSW)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:ALAN
Last Name:SCHIFFHAUER
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-2255
Mailing Address - Country:US
Mailing Address - Phone:814-248-0220
Mailing Address - Fax:
Practice Address - Street 1:636 SCALP AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-1640
Practice Address - Country:US
Practice Address - Phone:814-262-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW126941104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker