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General NPI Number Information
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NPI Number | 1487489134
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Entity Type | Organization
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Legal Business Name | SHUMATE MANAGEMENT LLC
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Dates
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Enumeration Date | 09/03/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 2900 OLD FOREST RD STE A
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City | LYNCHBURG
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State | VA
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Zip | 24501-2335
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Country | US
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Telephone | 206-235-0968
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 OLD FOREST RD STE A
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City | LYNCHBURG
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State | VA
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Zip | 24501-2335
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Country | US
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Telephone | 434-316-1826
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HOLLY SHUMATE
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Credential |
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Telephone | 206-235-0968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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