Provider Demographics
NPI:1194920892
Name:SHAFFER, CRYSTAL DAWN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:DAWN
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:DAWN
Other - Last Name:COPENHAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3230 WILLIAM PITT WAY
Mailing Address - Street 2:FAMILY SERVICES OF WESTERN PA
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238
Mailing Address - Country:US
Mailing Address - Phone:412-820-2050
Mailing Address - Fax:412-820-2050
Practice Address - Street 1:310 CENTRAL CITY PLAZA
Practice Address - Street 2:FAMILY SERVICES OF WESTERN PA
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068
Practice Address - Country:US
Practice Address - Phone:724-335-9883
Practice Address - Fax:724-335-2730
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW124599104100000X
PACW0170281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker