Provider Demographics
NPI:1346496064
Name:SHOEMAKER, JAMES R (LCSW, CADC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:SHOEMAKER
Suffix:
Gender:M
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 UPPER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:EFFORT
Mailing Address - State:PA
Mailing Address - Zip Code:18330-8196
Mailing Address - Country:US
Mailing Address - Phone:570-517-7153
Mailing Address - Fax:
Practice Address - Street 1:149 SAWMILL CT
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-8180
Practice Address - Country:US
Practice Address - Phone:570-517-7153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2017-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW019305101YA0400X
PASW010179L101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)