Justin Shaffer, LCSW, LAC, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.09923153 Issued in CO

Practice address

1024 S Lemay Ave
Fort Collins, CO 80524-3929

Phone

(970) 495-8020

Fax

(970) 495-7686

NPI assigned

Sep 19, 2013

Sex

Male

Sole proprietor

No

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

Enrolled in CO

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

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Therapy Services of the Rockies LLCGroup PAC ID 2769977099, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group NPD
• Therapy Services of the Rockies LLC

  • Mental Health Counselor
  • Fort Collins, CO
  • NPI 1003776816
  Medicare reassignment Care Compare group NPD
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1760492714
  Medicare reassignment NPD
• Poudre Valley Health Care Inc

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1962158857
  NPD
• Poudre Valley Health Care,Inc

  • Clinic/Center
  • Fort Collins, CO
  • NPI 1891837738
  NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1548696719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR STE B",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255540",
            "telephone_number": "970-494-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 S LEMAY AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243929",
            "telephone_number": "970-495-8020",
            "fax_number": "970-495-7686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1217 Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805243218",
            "country_code": "US",
            "telephone_number": "970-494-4200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Rocky Mountain Ave",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "CO",
            "postal_code": "805389004",
            "country_code": "US",
            "telephone_number": "970-624-2500",
            "fax_number": "970-624-1696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "JUSTIN",
        "credential": "LCSW, LAC, MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-19",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0000347",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09923153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sexual Assault Victim Advocate Center
• Sfcdp LLC.
• Shoshanna Shachtman, ED.D, LPC, NCC
• William A Shachtman, M.D.
• Hannah Elaine Shaffer
• Kristi M Shaffer, L.C.S.W.
• Monica Jean Shah, RN, BA
• Mason Sidney Shamis, MD
• Allison Danielle Shandra, M.S., CCC-SLP
• Hope Shane

• Clinical Social Worker in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.