| Doctor Name: | UMANATHAN SHANMUGAM |
| NPI Number: | 1164896684 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW, LBS |
| License Number: | BH002914 |
| Business Practice Address: | 9 Wellington Rd Apt 1 Upper Darby, PA - 190822443 |
| Business Phone Number: | 2678093978 |
| Business Fax Number: | |
| Mailing Address: | 9 Wellington Rd, Apt 1 UPPER DARBY |
| State: | PA |
| Postal Code: | 190822443 |
| Phone Number: | 2678093978 |
| Fax Number: | |
| NPI Enumeration Date: | 11/20/2015 |
| NPI Last Update Date: | 11/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | BH002914 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |