Provider Demographics
NPI:1265621718
Name:SCHUMAKER, PETER D (MA, LPC)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:D
Last Name:SCHUMAKER
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6633 WISE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-3725
Mailing Address - Country:US
Mailing Address - Phone:314-246-0560
Mailing Address - Fax:888-717-4730
Practice Address - Street 1:6633 WISE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-3725
Practice Address - Country:US
Practice Address - Phone:314-246-0560
Practice Address - Fax:888-717-4730
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
MO2008034939101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker