Individual
JENNIFER R SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
630 W KEARNEY ST, SPRINGFIELD, MO 65803-2508
(417) 761-5000
(417) 761-5011
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2016002398
MO
1041C0700X
Clinical Social Worker
Primary
2021042330
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14494829
CAQH
—
05
—
490074417
—
MO
Enumeration date
07/01/2019
Last updated
05/05/2026
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