Provider Demographics
NPI:1811779275
Name:VICTORIA SHUMARD
Entity type:Organization
Organization Name:VICTORIA SHUMARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUMARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:203-584-4575
Mailing Address - Street 1:935 OLD MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:VT
Mailing Address - Zip Code:05152-9713
Mailing Address - Country:US
Mailing Address - Phone:203-584-4575
Mailing Address - Fax:
Practice Address - Street 1:24 LIGHTHOUSE WAY
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-5612
Practice Address - Country:US
Practice Address - Phone:203-584-4575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty