Provider Demographics
NPI:1538264304
Name:SHUMAN, RANDEE LYNNE (LCSWR)
Entity type:Individual
Prefix:MS
First Name:RANDEE
Middle Name:LYNNE
Last Name:SHUMAN
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BELLOWS LN
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-2442
Mailing Address - Country:US
Mailing Address - Phone:845-708-0143
Mailing Address - Fax:845-639-9515
Practice Address - Street 1:15 BELLOWS LN
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-2442
Practice Address - Country:US
Practice Address - Phone:845-708-0143
Practice Address - Fax:845-639-9515
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR061556-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN553B1Medicare UPIN