Shafer, Susan Passafiume

Shafer, Susan Passafiume is an sole proprietor health care provider with primary practice located at 5010 Randell Pkwy Wilmington Nc 28403 , Wilmington NC 28403-2829. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Shafer, Susan Passafiume can be contacted via phone (910) 791-5719.

Contact Information

Primary practice address
5010 Randell Pkwy Wilmington Nc 28403 Wilmington NC 28403-2829
Phone: (910) 791-5719
Fax: (910) 799-8180
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1892 North Carolina
Behavioral Health & Social Service Providers / Professional 101YP2500X 7254 North Carolina
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 7254 North Carolina

Profile Details

NPI number 1386880664
LBN Legal business name Shafer, Susan Passafiume
Credentials LCMHC, LCAS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 17th, 2008
Last updated Jan 30th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386880664 NPPES
North Carolina MEDICAID 6104090

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