Individual
MS. MICHELLE LINN SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2345 S LYNHURST DR, INDIANAPOLIS, IN 46241-8630
(317) 247-8900
(317) 381-0691
Mailing address
3750 RIVERWOOD DR, INDIANAPOLIS, IN 46214-4029
(317) 387-1124
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
34000744A
IN
1041C0700X
Clinical Social Worker
Primary
34000744A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000388454
ANTHEM BCBS PROVIDER PIN
IN
Enumeration date
05/19/2006
Last updated
07/24/2007
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