Doctor Name: | ELIZABETH BOAN SHUMATE |
NPI Number: | 1023164126 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 0904003491 |
Business Practice Address: | 3204 Kenmore Dr Hampton, VA - 236613420 |
Business Phone Number: | 5402676264 |
Business Fax Number: | |
Mailing Address: | 3204 Kenmore Dr, HAMPTON |
State: | VA |
Postal Code: | 236613420 |
Phone Number: | 5402676264 |
Fax Number: | |
NPI Enumeration Date: | 01/25/2007 |
NPI Last Update Date: | 06/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 0904003491 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |