Shelley Ann Shaffer

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SHELLEY ANN SHAFFER

Doing business as

Shaffer Professional Services

Practice address

501 Arrowhead LN
Moose Lake, MN 55767-7707

Phone

(218) 380-0175

Fax

(218) 485-9105

NPI assigned

Sep 7, 2020

Last updated

Mar 1, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shelley A ShafferNPI 1558841320

Title

Owner

Phone

(218) 380-0175

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Shaffer Professional Services Doing business as

Electronic endpoints 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shelley A Shaffer, MS, LPCC

  • Professional Counselor
  • Sturgeon Lake, MN
  • NPI 1558841320

  Mental Health

  NPD Authorized official
• Heather Cronemiller, MA, LICSW

  • Clinical Social Worker
  • Moose Lake, MN
  • NPI 1649882861
  NPD
• Lindsay Marie Matti, MSW. LICSW

  • Clinical Social Worker
  • Duluth, MN
  • NPI 1962938704
  NPD

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

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1275147266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 463",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "557670463",
            "telephone_number": "218-380-0175",
            "fax_number": "218-485-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 ARROWHEAD LN",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "557677707",
            "telephone_number": "218-380-0175",
            "fax_number": "218-485-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLEY ANN SHAFFER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-07",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-380-0175"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275147266",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.shafferprofessionalservices.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fax",
            "address_1": "501 Arrowhead Ln",
            "city": "Moose Lake",
            "state": "MN",
            "country_code": "US",
            "postal_code": "557677707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Shaffer Professional Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shaffer Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James J. Ryan, M.D.
• Jeffrey Allen Schneider, CRNA
• Debra Kay Schuerman, PT
• Abby Marie Schultz
• Arun J Shankar, M.D.
• Taylor A Simonar, OTR/L
• Taylor A Soular, CNP, FNP-C
• Stacia Spiess, MA, CCC-SLP
• State of Minnesota
• STCH Moose Lake Opco LLC (St Croix Hospice)

• Mental Health Counselor in Moose Lake, MN
• Providers in Moose Lake, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.