Provider Demographics
NPI:1992072011
Name:SHAFFER, CHELSEA ANN (BS)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ANN
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MRS
Other - First Name:CHELSEA
Other - Middle Name:ANN
Other - Last Name:SHAFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:737 POWELL AVE
Mailing Address - Street 2:
Mailing Address - City:CRESSON
Mailing Address - State:PA
Mailing Address - Zip Code:16630-1357
Mailing Address - Country:US
Mailing Address - Phone:814-381-4123
Mailing Address - Fax:
Practice Address - Street 1:737 POWELL AVE
Practice Address - Street 2:
Practice Address - City:CRESSON
Practice Address - State:PA
Practice Address - Zip Code:16630-1357
Practice Address - Country:US
Practice Address - Phone:814-381-4123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor