Provider Demographics
NPI:1568188472
Name:SHIFFER, ELAINE J (MA, LMFT-IT)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:J
Last Name:SHIFFER
Suffix:
Gender:F
Credentials:MA, LMFT-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 OAKWOOD MALL DR STE 700
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-2617
Mailing Address - Country:US
Mailing Address - Phone:715-832-1678
Mailing Address - Fax:
Practice Address - Street 1:3410 OAKWOOD MALL DR STE 700
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-2617
Practice Address - Country:US
Practice Address - Phone:715-832-1678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1003-228106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist