Provider Demographics
NPI:1669641049
Name:SHEAFFER, MARLENE ELIZABETH (PCC)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:ELIZABETH
Last Name:SHEAFFER
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 POTH RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1324
Mailing Address - Country:US
Mailing Address - Phone:614-751-3749
Mailing Address - Fax:
Practice Address - Street 1:4440 POTH RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1324
Practice Address - Country:US
Practice Address - Phone:614-751-3749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE4337101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional