Provider Demographics
NPI:1730381740
Name:SCHAFFER, MARY ELEANOR (MA, LPC, ALPS)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELEANOR
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:MA, LPC, ALPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 W RUN RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-9042
Mailing Address - Country:US
Mailing Address - Phone:304-599-3573
Mailing Address - Fax:304-745-5067
Practice Address - Street 1:87 E MAIDEN ST
Practice Address - Street 2:SUITE #2
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4964
Practice Address - Country:US
Practice Address - Phone:304-745-5065
Practice Address - Fax:304-745-5067
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1514101YM0800X
PAPC005336101YP2500X
KYKY-0196101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health