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General NPI Number Information
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NPI Number | 1710517396
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Entity Type | Individual
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Provider Name | ERIC M. SHAFFER
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Gender | Male
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Dates
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Enumeration Date | 01/22/2020
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Last Update Date | 03/01/2025
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Provider Practice Location Address
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Address Line | 7811 TOBIE LANE
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City | LINCOLN
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State | NE
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Zip | 68516-3857
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Country | US
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Telephone | 850-666-3732
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6037
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City | LINCOLN
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State | NE
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Zip | 68506-0037
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Country | US
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Telephone | 850-666-3732
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 20696
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2193
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3169
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License Number State | NE
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