Basic Information
| Provider Information | |||||||||
| NPI: | 1013682038 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHAMUS | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPC, LMHC, LPCMH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 COLONY BLVD APT 146 | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198021409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3025304133 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 600 EVERGREEN DR STE 103 | ||||||||
| Address2: | |||||||||
| City: | GLEN MILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193421053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108923800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2021 | ||||||||
| LastUpdateDate: | 08/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | PC-0011096 | DE | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | 008553 | NY | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | PC013295 | PA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.