MEDICARE: LAUREN SHAFFER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R050518	NY

General Provider Information

NPI Number	:	1568018919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN SHAFFER LCSW

Provider Business Mailing Address
First Line	:	40 W 77TH ST STE 1F
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-5128
Country	:	US
Telephone Number	:	212-721-6122
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 W 77TH ST STE 1F
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-5128
Country	:	US
Telephone Number	:	212-721-6122
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2019
Last Update Date	:	08/12/2019

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Directions to “ LAUREN SHAFFER LCSW” Practice Location

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