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NPI Code Detail

MEDICARE: KAYLA K SHAFFER LPC

MEDICARE: KAYLA K SHAFFER LPC
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
1164W00000XLicensed Practical NurseLPN.136876.MEDSOH
2251S00000XCommunity/Behavioral Health AgencyCDCA.169967OH
3101YM0800XMental Health CounselorC.2103660OH
4101Y00000XCounselorC.1901526-TRNEOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851869556
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA K SHAFFER LPC
Provider Business Mailing Address
First Line : 4964 BELMONT AVE STE B
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44505-1001
Country : US
Telephone Number : 330-539-3200
Fax Number : 330-529-5241
Provider Business Practice Location Address
First Line : 1716 NORTH RD SE
Second Line :
City : WARREN
State : OH
Zip : 44484-2907
Country : US
Telephone Number : 330-539-3200
Fax Number : 330-529-5241
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2018
Last Update Date : 06/21/2024

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