Provider Demographics
NPI:1912379074
Name:SHUMAN, VALERY M (LCPC)
Entity Type:Individual
Prefix:
First Name:VALERY
Middle Name:M
Last Name:SHUMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 W LELAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-7043
Mailing Address - Country:US
Mailing Address - Phone:773-334-7117
Mailing Address - Fax:773-506-6499
Practice Address - Street 1:1207 W LELAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-7043
Practice Address - Country:US
Practice Address - Phone:773-334-7117
Practice Address - Fax:773-506-6499
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.005918101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional