Provider Demographics
NPI:1063909588
Name:SHUMATE, ERIN (CF-SLP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:SHUMATE
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 S BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-5725
Mailing Address - Country:US
Mailing Address - Phone:540-580-7211
Mailing Address - Fax:
Practice Address - Street 1:301 NORTH 9TH STREET
Practice Address - Street 2:EXCEPTIONAL EDUCATION
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219
Practice Address - Country:US
Practice Address - Phone:804-780-7312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202008499235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2202008499Medicaid