Provider Demographics
NPI:1649522707
Name:EMLER-SHAFFER, AMY (LCMHC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:EMLER-SHAFFER
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 LUCE RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05667-9101
Mailing Address - Country:US
Mailing Address - Phone:802-505-8248
Mailing Address - Fax:
Practice Address - Street 1:1619 LUCE RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:VT
Practice Address - Zip Code:05667-9101
Practice Address - Country:US
Practice Address - Phone:802-505-8248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0057621101YM0800X
VT068-57621101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health