Provider Demographics
NPI:1356670285
Name:SHUMWAY, CYNTHIA JANE (MSW, LISW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:JANE
Last Name:SHUMWAY
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:MRS
Other - First Name:JANIE
Other - Middle Name:
Other - Last Name:SHUMWAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LISW
Mailing Address - Street 1:10501 GOLF COURSE ROAD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10501 GOLF COURSE ROAD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114
Practice Address - Country:US
Practice Address - Phone:505-727-2369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-06671041C0700X
282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No282N00000XHospitalsGeneral Acute Care Hospital