Shumway Johnson, Stacey
Shumway Johnson, Stacey is an sole proprietor health care provider with primary practice located at 310 Washington St , Portsmouth OH 45662-3914. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Shumway Johnson, Stacey can be contacted via phone (844) 505-4500.Contact Information
Primary practice address
310 Washington St
Portsmouth OH 45662-3914
Phone: (844) 505-4500
Fax: (740) 353-8889
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 104053 | Kentucky |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | E.0600469-SUPV | Ohio |
Profile Details
| NPI number | 1821289034 |
|---|---|
| LBN Legal business name | Shumway Johnson, Stacey |
| Credentials | LPCC-S, LICDC-CS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 5th, 2007 |
| Last updated | Mar 17th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821289034 | NPPES |
| Other | 11816332 | CAQH | |
| Other | 000000530777 | CAQH | |
| MEDICAID | 7100283540 | CAQH |
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