Individual
LOGAN ALEXANDER SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC-MHSP
Contact information
Practice address
1570 WAVERLY RD, KINGSPORT, TN 37664-2523
(423) 224-1353
Mailing address
1445 BRIDWELL ST, KINGSPORT, TN 37664-3307
(423) 579-8047
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8472
TN
101YP2500X
Professional Counselor
Primary
8472
TN
Other
Enumeration date
01/05/2026
Last updated
02/10/2026
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