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
Fax: (740) 353-8889
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821289034 NPPES
Other 11816332 CAQH
Other 000000530777 CAQH
MEDICAID 7100283540 CAQH

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