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General NPI Number Information
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NPI Number | 1578765053
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Entity Type | Individual
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Provider Name | VICKI LYNN SHUMAKER M.A., LMSW, CAADC
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Gender | Female
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 04/29/2011
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Provider Practice Location Address
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Address Line | 450 MEADOW RUN DR STE 400
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City | HASTINGS
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State | MI
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Zip | 49058-9054
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Country | US
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Telephone | 269-945-8806
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Fax | 269-945-8831
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Provider Business Mailing Address
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Address Line | 450 MEADOW RUN DR STE 400
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City | HASTINGS
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State | MI
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Zip | 49058-9054
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Country | US
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Telephone | 269-945-8806
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Fax | 269-945-8831
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801089226
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License Number State | MI
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