Amy M Shaffer, LPCC
Individual provider Active NPI Counselor · Rush, KY
NPI 1871842971 · NPPES record last updated Jan 16, 2017
Key facts
- NPI
- 1871842971
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 103630 (KY)
- Practice address
- 2901 Pigeon Roost Rd
Rush, KY 41168-8132 - Phone
- (606) 928-6648
- Fax
- (606) 547-4359
- NPI assigned
- Sep 5, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103630 | KY | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 103630 | KY | Yes |
Addresses
Primary practice location
2901 Pigeon Roost Rd
Rush, KY 41168-8132
Mailing address
5679 State Route 207
Wurtland, KY 41144-7439
Phone (606) 928-6648
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30610026 | Medicaid | KY |
Other providers in Rush, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.