Shaffer, Tierney

Shaffer, Tierney is an sole proprietor health care provider with primary practice located at 19 Wayside Ln , Ponte Vedra FL 32081-6005. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Shaffer, Tierney can be contacted via phone (303) 241-1017.

Contact Information

Primary practice address
19 Wayside Ln Ponte Vedra FL 32081-6005
Phone: (303) 241-1017
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW17768 Florida

Profile Details

NPI number 1134424336
LBN Legal business name Shaffer, Tierney
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 19th, 2011
Last updated Jan 11th, 2021 - about 5 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 1134424336 NPPES
Colorado MEDICAID 3032411017

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