Amy Jo Shaffer

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC012945 Issued in PA

Practice address

105 Concord St
Union City, PA 16438-1306

Phone

(814) 790-2628

Fax

(814) 835-2196

NPI assigned

Jan 12, 2021

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": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1841889151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15718 ROUTE 8",
            "city": "UNION CITY",
            "state": "PA",
            "postal_code": "164389165",
            "telephone_number": "814-664-0071",
            "fax_number": "814-835-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CONCORD ST",
            "city": "UNION CITY",
            "state": "PA",
            "postal_code": "164381306",
            "telephone_number": "814-790-2628",
            "fax_number": "814-835-2196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 Miles St",
            "address_purpose": "LOCATION",
            "city": "Union City",
            "state": "PA",
            "postal_code": "164381463",
            "country_code": "US",
            "telephone_number": "814-790-2628",
            "fax_number": "814-835-2196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "AMY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC012945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Union City, PA
• Providers in Union City, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.