Provider Demographics
NPI:1548859986
Name:SCHAFFSTALL, EMILY GRACE (LMSW)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:GRACE
Last Name:SCHAFFSTALL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-2008
Mailing Address - Country:US
Mailing Address - Phone:716-796-7673
Mailing Address - Fax:
Practice Address - Street 1:844 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-2008
Practice Address - Country:US
Practice Address - Phone:716-796-7673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110031-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical