Provider Demographics
NPI:1275756249
Name:SHUMARD, BARBARA H (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:H
Last Name:SHUMARD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3661 TERRACE HILLS LN
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-4891
Mailing Address - Country:US
Mailing Address - Phone:734-425-0396
Mailing Address - Fax:734-425-0396
Practice Address - Street 1:3661 TERRACE HILLS LN
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-4891
Practice Address - Country:US
Practice Address - Phone:734-425-0396
Practice Address - Fax:734-425-0396
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101005924106H00000X
MI68010147161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0963228OtherBCN
0963228OtherBCBS
126240OtherVALUE OPTIONS