Provider Demographics
NPI:1992853188
Name:SHEAFFER, AMY J (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:J
Last Name:SHEAFFER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 W FRANKLIN ST STE 230
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-5411
Mailing Address - Country:US
Mailing Address - Phone:707-295-0127
Mailing Address - Fax:
Practice Address - Street 1:1020 W FRANKLIN ST STE 230
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702
Practice Address - Country:US
Practice Address - Phone:707-295-0127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC23534106H00000X
IDLMFT-5404106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist