Susan Passafiume Shafer, LCMHC, LCAS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7254 Issued in NC

Practice address

5010 Randell Pkwy Wilmington NC 28403
Wilmington, NC 28403-2829

Phone

(910) 791-5719

Fax

(910) 799-8180

NPI assigned

Dec 17, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Undefined Non-Physician Type (Specify)

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: susanshafer@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Health With Heart Counseling LLC

  • Mental Health Counselor
  • Wilmington, NC
  • NPI 1063274017

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD
• Assistedcare, Inc

  • Home Health Agency
  • Leland, NC
  • NPI 1821193103
  NPD (past)

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1386880664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 RANDELL PKWY WILMINGTON NC 28403",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032829",
            "telephone_number": "910-791-5719",
            "fax_number": "910-799-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 RANDELL PKWY WILMINGTON NC 28403",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032829",
            "telephone_number": "910-791-5719",
            "fax_number": "910-799-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "SUSAN",
        "middle_name": "PASSAFIUME",
        "credential": "LCMHC, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-17",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1892",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "7254",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "7254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104090",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Severt
• Anna Sevic
• Jennifer Marie Shackelford, PA-C
• Jarrel Lynne Shackleford, PA-C
• Holly Shadoin, OTR/L
• Brianna Shaffer
• Holly Candice Shaffer
• Joseph Crockett Shaffer II
• Michelle Leslie Shaffer, CCC-SLP
• Charlotte Shah, LCMHC, LCAS, CSI

• Mental Health Counselor in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.