Healthcare Provider Details

I. General information

NPI: 1558607994
Provider Name (Legal Business Name): BRADLEY ROE SHUMATE M.S, M.A., LMHC, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BRAD SHUMATE M.S, M.A., LMHC, LPC

II. Dates (important events)

Enumeration Date: 12/12/2012
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3532 S WAPITI LN
SPOKANE VALLEY WA
99206-1208
US

IV. Provider business mailing address

3532 S WAPITI LN
SPOKANE VALLEY WA
99206-1208
US

V. Phone/Fax

Practice location:
  • Phone: 360-600-1070
  • Fax: 509-919-4494
Mailing address:
  • Phone: 360-600-1070
  • Fax: 509-919-4494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC.LH.00005889
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC3790
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: