Kayla K Shaffer, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C.2103660 Issued in OH

Practice address

1716 North Rd SE
Warren, OH 44484-2907

Phone

(330) 539-3200

Fax

(330) 529-5241

NPI assigned

Nov 12, 2018

Last updated

Jun 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/openwatercounseling/r4/

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

• Open Water Counseling and Recovery, LLC

  • Community/Behavioral Health Agency
  • Warren, OH
  • NPI 1447877147
  NPD
• Open Water Counseling and Recovery, LLC

  • Mental Health Counselor
  • Warren, OH
  • NPI 1932747888
  NPD (past)

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1851869556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4964 BELMONT AVE STE B",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051001",
            "telephone_number": "330-539-3200",
            "fax_number": "330-529-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 NORTH RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842907",
            "telephone_number": "330-539-3200",
            "fax_number": "330-529-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "KAYLA",
        "middle_name": "K",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2024-06-21",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.1901526-TRNE",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2103660",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.136876.MEDS",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "CDCA.169967",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0332221",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Senne
• Christine H Sesonsky, MA-CCC
• Heather N Setser
• Alison Sferra
• Maggie Shackelford
• Rayven Shaffer
• Archna Shah, OT
• Devarsh Nilesh Shah, M.D.
• Hem Shah
• Reshashree Shah, MD

• Mental Health Counselor in Warren, OH
• Providers in Warren, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.