Provider Demographics
NPI:1477880318
Name:SHULMAN, ELIZABETH (LMFT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1018
Mailing Address - Street 2:7 SPRING STREET
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-1018
Mailing Address - Country:US
Mailing Address - Phone:860-344-9558
Mailing Address - Fax:860-347-6265
Practice Address - Street 1:7 SPRING ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-2238
Practice Address - Country:US
Practice Address - Phone:860-344-9558
Practice Address - Fax:860-347-6265
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-13
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001275106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist