MEDICARE: MRS. BETH A. SCHUMACHER MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801035828	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8008974530	OTHER	MI	BLUE SHIELD

General Provider Information

NPI Number	:	1639276041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BETH A. SCHUMACHER MSW

Provider Business Mailing Address
First Line	:	1 HURLEY PLZ
Second Line	:	5TH FLOOR S.O.N.
City	:	FLINT
State	:	MI
Zip	:	48503-5902
Country	:	US
Telephone Number	:	810-762-7038
Fax Number	:	810-760-0440

Provider Business Practice Location Address
First Line	:	2700 ROBERT T LONGWAY BLVD STE A
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48503-2190
Country	:	US
Telephone Number	:	810-235-2599
Fax Number	:	810-235-2836

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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