Individual provider Active NPI

Anna Shaffer, ED.S, MS, CRC, LPC

  • School Psychologist
  • Spencer, WV
National Provider Identifier
1689289506
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
2455 Issued in WV
Practice address
802 Madison Ave
Spencer, WV 25276-1930
Phone
(304) 927-6405
Fax
(304) 927-6440
NPI assigned
Sep 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2455 WV
School Psychologist 103TS0200X 2455 WV Primary

Addresses

Primary practice location

802 Madison Ave
Spencer, WV 25276-1930

Mailing address

802 Madison Ave
Spencer, WV 25276-1930
Phone (304) 927-6405

Other practice location 1

511 Morris St
Charleston, WV 25301-1326
Phone (304) 525-7851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20260225003344 WV Practitioner - Mental Health Counselor 8325529522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

60 Onyx LN
Elkview, WV 25071-7233

PO Box
Suite 16309
Jacksonville, FL 32245

PO Box
Suite 3466
Charleston, WV 25334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2455WVMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prestera Center for Mental Health Services Inc CurrentSince Jan 15, 2026 Accepting new patients
Prestera Center for Mental Health Services Inc CurrentSince Jan 15, 2026 Accepting new patients

Locations

99 Cracker Barrel Dr
Ste 100
Barboursville, WV 25504
Phone 30452578512514

511 Morris St
Charleston, WV 25301
Phone (304) 341-0511

376 Kenmore Dr
Danville, WV 25053
Phone (304) 369-1930

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1689289506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 MADISON AVE",
            "city": "SPENCER",
            "state": "WV",
            "postal_code": "252761930",
            "telephone_number": "304-927-6405",
            "fax_number": "304-927-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 MADISON AVE",
            "city": "SPENCER",
            "state": "WV",
            "postal_code": "252761930",
            "telephone_number": "304-927-6405",
            "fax_number": "304-927-6440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 Morris St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011326",
            "country_code": "US",
            "telephone_number": "304-525-7851",
            "fax_number": "304-525-1073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "ANNA",
        "credential": "ED.S, MS, CRC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "2455",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "WV",
            "license": "2455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, WV

Sources for this page

Verify at the official NPI Registry.