# CARLA M. SHAFFER, PHD., LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215474614
- **Authorized official:** DR. CARLA SHAFFER PHD., LCP (LICENSED CLINICAL PSYCHOLOGIST)
- **Authorized official phone:** (804) 873-8755

## Contact information

- **Practice address:** 17 E MAIN ST, \#3, RICHMOND, VA 23219-2109
- **Practice address phone:** (804) 495-0676
- **Mailing address:** 3649 STONE HARBOR DR, MIDLOTHIAN, VA 23113-9200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | 0810005414 | VA | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 0810005414 | VA | Yes |

## Other

- **Enumeration date:** 01/23/2017
- **Last updated:** 01/23/2017