Provider Demographics
NPI:1942362629
Name:SHUMWAY, HELEN MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:MARIE
Last Name:SHUMWAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3637 SANTA ANITA DR
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7441
Mailing Address - Country:US
Mailing Address - Phone:435-632-7488
Mailing Address - Fax:
Practice Address - Street 1:166 N 300 W # 4
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-2770
Practice Address - Country:US
Practice Address - Phone:435-632-7488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4785776-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical