Provider Demographics
NPI:1801973482
Name:JOANNE M SCHAFFER MSW LCSW PA
Entity type:Organization
Organization Name:JOANNE M SCHAFFER MSW LCSW PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:919-562-9922
Mailing Address - Street 1:1618 US 1 HWY
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27596-9219
Mailing Address - Country:US
Mailing Address - Phone:919-562-9922
Mailing Address - Fax:919-562-9917
Practice Address - Street 1:1618 US 1 HWY
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27596-9219
Practice Address - Country:US
Practice Address - Phone:919-562-9922
Practice Address - Fax:919-562-9917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0040221041C0700X
251S00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC50300472Medicaid
2329121Medicare PIN