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General NPI Number Information
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NPI Number | 1659574671
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Entity Type | Individual
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Provider Name | DEEDEE SHAFFER LPC, LAC, NCC
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 02/05/2021
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Provider Practice Location Address
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Address Line | 1852 IRWIN DR BLDG 1059
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City | COLORADO SPRINGS
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State | CO
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Zip | 80913-4176
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Country | US
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Telephone | 719-526-8735
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Fax |
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Provider Business Mailing Address
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Address Line | 695 SADDLEMOUNTAIN RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-2029
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Country | US
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Telephone | 719-243-2184
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5793
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 418
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License Number State | CO
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