Provider Demographics
NPI:1326210758
Name:SHULMAN, DENISE M (LPC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5028 WOODCREST LN
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-1320
Mailing Address - Country:US
Mailing Address - Phone:971-300-9991
Mailing Address - Fax:
Practice Address - Street 1:14511 WESTLAKE DR
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-7783
Practice Address - Country:US
Practice Address - Phone:971-300-9991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2014-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3172101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional