Individual
KAYLA K SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1716 NORTH RD SE, WARREN, OH 44484-2907
(330) 539-3200
(330) 529-5241
Mailing address
4964 BELMONT AVE STE B, YOUNGSTOWN, OH 44505-1001
(330) 539-3200
(330) 529-5241
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C.1901526-TRNE
OH
101YM0800X
Mental Health Counselor
Primary
C.2103660
OH
164W00000X
Licensed Practical Nurse
LPN.136876.MEDS
OH
251S00000X
Community/Behavioral Health Agency
CDCA.169967
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0332221
—
OH
Enumeration date
11/12/2018
Last updated
06/21/2024
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