Healthcare Provider Details

I. General information

NPI: 1982513396
Provider Name (Legal Business Name): SHANNA HAFFNER MS, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 HIGHWAY 18 STE 304
EAST BRUNSWICK NJ
08816-1407
US

IV. Provider business mailing address

190 HIGHWAY 18 STE 304
EAST BRUNSWICK NJ
08816-1407
US

V. Phone/Fax

Practice location:
  • Phone: 732-333-8520
  • Fax: 732-333-8530
Mailing address:
  • Phone: 732-333-8520
  • Fax: 732-333-8530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00987300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: