Evonna Shaffer

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

S31392566460902 Issued in NJ

Practice address

770 Woodlane Rd
None
Mt Holly, NJ 08060-3804

Phone

(609) 267-5928

NPI assigned

Jul 14, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1447667274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ROLLING HILLS DR E",
            "address_2": "NONE",
            "city": "WESTAMPTON",
            "state": "NJ",
            "postal_code": "08060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 WOODLANE RD",
            "address_2": "NONE",
            "city": "MT HOLLY",
            "state": "NJ",
            "postal_code": "080603804",
            "telephone_number": "609-267-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "EVONNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "S31392566460902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seniors Appointment Transport Service
• Robert Glenn Sentman, P.T., O.C.S.
• Services to Overcome Drug Abuse Among Teenagers, Inc.
• Services to Overcome Drug Abuse Among Teenagers, Inc.
• Yelena Shabelnik, DO
• Parth Shah
• Purviben Shah, M.D.
• Stuart Shalit, D.O.
• Amita Sharma, MD
• Walter Richard Sheilds Jr., RN

• Mental Health Counselor in Mt Holly, NJ
• Providers in Mt Holly, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; 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.