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General NPI Number Information
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NPI Number | 1659314565
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Entity Type | Individual
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Provider Name | MARK ALAN SHAFFER LCSW-C
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 1104 HEALTHWAY DR
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City | SALISBURY
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State | MD
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Zip | 21804-4469
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Country | US
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Telephone | 410-219-5483
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Fax | 410-219-5486
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Provider Business Mailing Address
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Address Line | PO BOX 1978
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City | SALISBURY
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State | MD
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Zip | 21802-1978
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Country | US
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Telephone | 410-749-1015
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Fax | 410-749-0654
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 23436
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License Number State | MD
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