Provider Demographics
NPI:1427537554
Name:SHUMATE, TABITHA A (BA)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:A
Last Name:SHUMATE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 ROBIN HOOD DR NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3336
Mailing Address - Country:US
Mailing Address - Phone:423-331-2365
Mailing Address - Fax:
Practice Address - Street 1:1000 S LEE HWY
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-5899
Practice Address - Country:US
Practice Address - Phone:423-331-2365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist