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General NPI Number Information
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NPI Number | 1326496803
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Entity Type | Individual
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Provider Name | KRISTOPHER MARSHALL DEAN SHAFFER LPC
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Gender | Male
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Dates
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Enumeration Date | 05/25/2016
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Last Update Date | 05/25/2016
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Provider Practice Location Address
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Address Line | 3410 OLD FOREST RD
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City | LYNCHBURG
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State | VA
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Zip | 24501-2915
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Country | US
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Telephone | 434-455-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1765 WATERLICK RD
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City | LYNCHBURG
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State | VA
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Zip | 24501-7229
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Country | US
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Telephone | 434-382-8016
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701006562
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License Number State | VA
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