MR. IAN DAVID SHAFER (NPI# 1639575038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639575038 |
| Entity Type | Individual |
| Full Name | MR. IAN DAVID SHAFER |
| Credential | MA, LPC |
| Practice Address |
4025 Holt Rd Ste 205 Holt MI 48842-6019 |
| Practice Telephone | 5173166600 |
| Mailing Telephone | 5178817231 |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2018-03-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 6401012915 | MI | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
6401012915 | MI | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
6401012915 | MI | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 207 1st St, Jackson, MI 492012102 | 5179980129 | 5179980005 |
| Street Address |
4025 HOLT RD STE 205 |
| City | HOLT |
| State | MI |
| Zip Code | 48842-6019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881197168 | Peace of Mind Counseling, Consulting, and Supervision LLC | Counselor | 4025 Holt Rd Ste 205, Holt, MI 48842-6019 | 2018-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730708538 | Dylan Voris | Psychologist | 4523 E Willoughby Rd., Holt, MI 48842 | 2020-04-11 |
| 1013458835 | Allison Ann Pingston | Specialist/Technologist | 23747 Rolling Ridge Ln., Holt, MI 48842 | 2017-03-13 |
| 1528417706 | Marybeth Timotiwu | Technician, Other | 3940 Acorn Cir, Holt, MI 48842 | 2016-06-08 |
| 1831593623 | Mary Nelson | Rehabilitation Practitioner | 3860 Wachtel Drive, Holt, MI 48842 | 2014-10-22 |
| 1598869703 | Nicole Elizabeth Durnin | Pharmacist | 2018 N. Cedar Street, Suite A, Holt, MI 48842 | 2006-09-08 |
| 1225130560 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 2240 Cedar St, Holt, MI 48842 | 2006-09-05 |
| 1073622973 | Marilyn Viera | Family Medicine | 2380 Cedat St, Holt, MI 48842 | 2006-08-30 |
| 1942228291 | Stephen N. Glover | Pharmacist | 2390 N. Cedar St., Holt, MI 48842 | 2006-07-17 |
| 1740244169 | Pamela Thompson | Family Medicine | 4221 Charlar Dr, Holt, MI 48842 | 2006-04-13 |
| 1407847387 | Amy Lynn Cousineau | Optometrist | 2040 Aurelius Rd Ste 20, Holt, MI 48842 | 2005-10-31 |
| Find all providers in zip 48842 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306158274 | Anna M. Walton | Counselor | 4672 Harper Rd, Holt, MI 48842-9671 | 2010-07-08 |
| 1306056213 | Sharon Ann Peek | Counselor | 4717 Holt Road, Holt, MI 48842-1663 | 2007-05-23 |
| 1710114707 | Dbt Center of Michigan, LLC | Counselor | 4205 Charlar Dr, Suite 3, Holt, MI 48842-6810 | 2009-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073367 | Lisa Joanne Lindemann | Counselor | 764 Basswood Dr, Rochester Hills, MI 48309-1713 | 2020-11-08 |
| 1891396891 | Sonda Lasha Thomas | Counselor | 38 W Henry St, River Rouge, MI 48218-1359 | 2020-11-05 |
| 1700487931 | Cjt Solutions | Counselor | 351 Coventry Ln, Mason, MI 48854-1162 | 2020-11-04 |
| 1356942932 | Ann Marie Mcpherson | Counselor | 25551 Pine View Ave, Warren, MI 48091-3888 | 2020-11-02 |
| 1265032148 | Ashley Capaldi | Counselor | 8500 Oak Park Blvd, Oak Park, MI 48237-1848 | 2020-10-29 |
| 1538769542 | Sherie Justine Posie | Counselor | 16000 W 9 Mile Rd Ste 115, Southfield, MI 48075-4800 | 2020-10-28 |
| 1477152445 | True North Holistic Health and Wellness, LLC | Counselor | 5472 Belsay Rd, Grand Blanc, MI 48439-9129 | 2020-10-21 |
| 1881293819 | Breakthrough L.L.C. | Counselor | 38847 Parkview Dr, Clinton Twp, MI 48036-3826 | 2020-10-21 |
| 1790384998 | Amanda Nicole Lambert | Counselor | 1919 Gratiot Ave, Saginaw, MI 48602-2763 | 2020-10-20 |
| 1285233437 | Emmitt Melvin Davis Jr. | Counselor | 316 Morris Ave Ste 200, Muskegon, MI 49440-1154 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.