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General NPI Number Information
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NPI Number | 1922767029
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Entity Type | Individual
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Provider Name | ALEXANDER MICHAEL SHAFFER LSW
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Gender | Male
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Dates
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Enumeration Date | 12/16/2021
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 8626 E 116TH ST STE 250
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City | FISHERS
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State | IN
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Zip | 46038-2853
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Country | US
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Telephone | 317-759-4550
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 DOUGLAS DR
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City | CARMEL
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State | IN
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Zip | 46033-2324
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Country | US
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Telephone | 317-696-3147
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 33010500A
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License Number State | IN
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