Provider Demographics
NPI:1578190831
Name:SHAUNA E. SUMMERS, PH.D., LLC
Entity type:Organization
Organization Name:SHAUNA E. SUMMERS, PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAUNA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:401-644-7417
Mailing Address - Street 1:31 HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-2115
Mailing Address - Country:US
Mailing Address - Phone:401-644-7417
Mailing Address - Fax:877-603-8031
Practice Address - Street 1:31 HARVARD AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-2115
Practice Address - Country:US
Practice Address - Phone:401-644-7417
Practice Address - Fax:877-603-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-26
Last Update Date:2024-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty