Provider Demographics
NPI:1669557401
Name:SHUMAKER, MICHELLE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SHUMAKER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ADAMS
Other - Last Name:RABE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:9120 CONNECTICUT ST STE A
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7015
Mailing Address - Country:US
Mailing Address - Phone:219-793-1233
Mailing Address - Fax:219-793-1244
Practice Address - Street 1:9120 CONNECTICUT ST STE A
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7015
Practice Address - Country:US
Practice Address - Phone:219-793-1233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004077A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical