Michael Jack Shoemaker, MA, LMHC, DMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

00005040 Issued in WA

Practice address

3859 Martin Way E
Olympia, WA 98506-5268

Phone

(360) 704-7170

Fax

(360) 754-1194

NPI assigned

Jun 8, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Behavioral Health Resources

  • Community/Behavioral Health Agency
  • Olympia, WA
  • NPI 1831594068
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013446558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3857 MARTIN WAY E",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065268",
            "telephone_number": "360-704-7170",
            "fax_number": "360-754-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3859 MARTIN WAY E",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065268",
            "telephone_number": "360-704-7170",
            "fax_number": "360-754-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "MICHAEL",
        "middle_name": "JACK",
        "credential": "MA, LMHC, DMHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "00005040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Shestopal Childres, CRNA
• Shi Center PLLC
• Irene Rose Shields, M.A., CCC-SLP
• Naomi Michelle Shipley
• Marianna Shkolnik, CNIM
• Meave Mageir Short, LMP
• Patricia Marie Short, PSYD
• Shambhu Shrestha, RN, BSN
• Jabi Elijah Shriki, M.D.
• Tamara Janel Rosser Shultz, LMFT

• Mental Health Counselor in Olympia, WA
• Providers in Olympia, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.