Provider Demographics
NPI:1003939984
Name:CUMMINGS, LORRAINE ELISE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:ELISE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LORRAINE
Other - Middle Name:ELISE
Other - Last Name:MALM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 652
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-0652
Mailing Address - Country:US
Mailing Address - Phone:626-201-1717
Mailing Address - Fax:951-797-0266
Practice Address - Street 1:1145 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-5013
Practice Address - Country:US
Practice Address - Phone:626-201-1717
Practice Address - Fax:951-797-0266
Is Sole Proprietor?:No
Enumeration Date:2007-04-07
Last Update Date:2024-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEMSW21871041C0700X
TN84971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW 17288 BMedicare ID - Type UnspecifiedPROVIDER LEGACY NUMBER