Healthcare Provider Details

I. General information

NPI: 1205266418
Provider Name (Legal Business Name): ASHLEY SROKOWSKI SHAFER M.ED. LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2013
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 AKRON GENERAL AVE
AKRON OH
44307-2432
US

IV. Provider business mailing address

3447 GRANTON AVE
CLEVELAND OH
44111-2971
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-1559
  • Fax: 303-344-5802
Mailing address:
  • Phone: 404-225-6729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberE.1700150-SUPV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.1200276-CR
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: