Provider Demographics
NPI:1679185078
Name:SCHAFFSTALL, JENNIFER MARY (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MARY
Last Name:SCHAFFSTALL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CHANCELLOR LN
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-5019
Mailing Address - Country:US
Mailing Address - Phone:716-984-1157
Mailing Address - Fax:
Practice Address - Street 1:9 CHANCELLOR LN
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-5019
Practice Address - Country:US
Practice Address - Phone:716-984-1157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00650-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health