Zachary Shaeffer, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC50080561 Issued in DC

Practice address

3420 NE 147TH St Apt 4
Lake Forest Park, WA 98155-7850

Phone

(202) 713-6826

NPI assigned

Jun 28, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1194176420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 HOWARD RD SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200205805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 NE 147TH ST APT 4",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981557850",
            "telephone_number": "202-713-6826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 Howard Rd SE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200205805",
            "country_code": "US",
            "telephone_number": "202-939-5280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAEFFER",
        "first_name": "ZACHARY",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "60963612",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50080561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Roklen
• Nicole Susanne Ruttenberg, MS, LMFTA
• Laura Sandusky
• Jessica Sather, LMFTA
• Andrea Eva Schommer, PHARM D.
• Gwendolyn Kathleen Shattuck, LMT
• Anne Shumway-Cook, PT, PHD
• Bonita Shuffain Siegel, LICSW
• Kristina Smart, MS
• Brian D Smith, PHD, M.ED

• Clinical Social Worker in Lake Forest Park, WA
• Providers in Lake Forest Park, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.