MEDICARE: MAGGIE SHUMPERT

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	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093191769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAGGIE SHUMPERT

Provider Business Mailing Address
First Line	:	573 HUNTINGTON DR
Second Line	:
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29169-4409
Country	:	US
Telephone Number	:	803-586-8303
Fax Number	:

Provider Business Practice Location Address
First Line	:	418 BARR RD
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29072-2363
Country	:	US
Telephone Number	:	803-805-4361
Fax Number	:	803-291-5959

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

Provider Enumeration Date	:	08/05/2015
Last Update Date	:	09/23/2025

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Directions to “ MAGGIE SHUMPERT ” Practice Location

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