Provider Demographics
NPI:1427480649
Name:SCHIEFER, SHANNON (MA, LPC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:SCHIEFER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 S LAKESHORE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7047
Mailing Address - Country:US
Mailing Address - Phone:480-331-4439
Mailing Address - Fax:480-775-0660
Practice Address - Street 1:4525 S LAKESHORE DR STE 102
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7047
Practice Address - Country:US
Practice Address - Phone:480-331-4439
Practice Address - Fax:480-775-0660
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ-LPC-12136101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor