Active NPI
Stephanie Shaffer, PH.D.
- Clinical Psychologist
- Colorado Springs, CO
National Provider Identifier
1740568823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3612
- Practice address
- 3225 International Cir Ste 102
Colorado Springs, CO 80910-3161 - Phone
- (719) 471-1466
- NPI assigned
- Jul 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3612 | CO | Primary |
Addresses
Primary practice location
3225 International Cir Ste 102
Colorado Springs, CO 80910-3161
Mailing address
3225 International Cir Ste 102
Colorado Springs, CO 80910-3161
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 14, 2016 through Apr 14, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3612 | CO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718496000000",
"number": "1740568823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3225 INTERNATIONAL CIR STE 102",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809103161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3225 INTERNATIONAL CIR STE 102",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809103161",
"telephone_number": "719-471-1466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-24",
"last_updated": "2024-06-16",
"certification_date": "2024-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "3612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.