Provider Demographics
NPI:1316796469
Name:SHAFFER, ASHLEY ANN (LMHCA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ANN
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6211 OLD HIGHWAY RD
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-9869
Mailing Address - Country:US
Mailing Address - Phone:803-371-2807
Mailing Address - Fax:
Practice Address - Street 1:801 CLANTON RD # RC114
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-1372
Practice Address - Country:US
Practice Address - Phone:704-840-6088
Practice Address - Fax:800-506-0738
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19985101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health