Provider Demographics
NPI:1801785563
Name:SHAFFERY, ALAN (LSW)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:SHAFFERY
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 1:1198 LAKEWOOD RD STE 102
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2243
Mailing Address - Country:US
Mailing Address - Phone:732-605-6364
Mailing Address - Fax:
Practice Address - Street 1:1198 LAKEWOOD RD STE 202
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2243
Practice Address - Country:US
Practice Address - Phone:732-605-6364
Practice Address - Fax:732-605-6364
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07042600101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor