Provider Demographics
NPI:1386881498
Name:SHUMWAY, CLAYTON (LCSW)
Entity type:Individual
Prefix:
First Name:CLAYTON
Middle Name:
Last Name:SHUMWAY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 CAMBRIA DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-2871
Mailing Address - Country:US
Mailing Address - Phone:801-687-2736
Mailing Address - Fax:
Practice Address - Street 1:69 N 490 W
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2264
Practice Address - Country:US
Practice Address - Phone:801-687-2736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT340237-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical