Provider Demographics
NPI:1376252031
Name:SHUMATE, BRIANNA (LCSW, MED)
Entity Type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:
Last Name:SHUMATE
Suffix:
Gender:F
Credentials:LCSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7246 ALEXANDRA DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-8143
Mailing Address - Country:US
Mailing Address - Phone:302-545-5572
Mailing Address - Fax:
Practice Address - Street 1:7246 ALEXANDRA DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-8143
Practice Address - Country:US
Practice Address - Phone:302-545-5572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00121681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical