Provider Demographics
NPI:1811555030
Name:SHIFTER, MICHAEL ARTHUR (LCPC, LPC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ARTHUR
Last Name:SHIFTER
Suffix:
Gender:M
Credentials:LCPC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6421 DREW DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4641
Mailing Address - Country:US
Mailing Address - Phone:240-801-6463
Mailing Address - Fax:
Practice Address - Street 1:4716 S CHELSEA LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3720
Practice Address - Country:US
Practice Address - Phone:240-801-6463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
VA0701010194101YP2500X
MDLC10233101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health