Provider Demographics
NPI:1043252547
Name:LUCINDA CUMMINGS, PH.D., LP, LLC
Entity Type:Organization
Organization Name:LUCINDA CUMMINGS, PH.D., LP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:763-546-1796
Mailing Address - Street 1:8085 WAYZATA BLVD
Mailing Address - Street 2:#212
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1453
Mailing Address - Country:US
Mailing Address - Phone:763-546-1796
Mailing Address - Fax:763-546-8264
Practice Address - Street 1:8085 WAYZATA BLVD
Practice Address - Street 2:#212
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1453
Practice Address - Country:US
Practice Address - Phone:763-546-1796
Practice Address - Fax:763-546-8260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2102103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN43P88CUOtherBLUE CROSS BLUE SHIELD
MN5550521Medicaid