Provider Demographics
NPI:1154483600
Name:CUMMING, MARY LORENE (NE LMHP CP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LORENE
Last Name:CUMMING
Suffix:
Gender:F
Credentials:NE LMHP CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 E 10TH ST
Mailing Address - Street 2:P.O. BOX 297
Mailing Address - City:OGALLALA
Mailing Address - State:NE
Mailing Address - Zip Code:69153-1442
Mailing Address - Country:US
Mailing Address - Phone:308-284-6519
Mailing Address - Fax:308-284-6513
Practice Address - Street 1:103 E 10TH ST
Practice Address - Street 2:
Practice Address - City:OGALLALA
Practice Address - State:NE
Practice Address - Zip Code:69153-1442
Practice Address - Country:US
Practice Address - Phone:308-284-6519
Practice Address - Fax:308-284-6513
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE743101YM0800X
NE623101YP2500X
NE1024101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
072456OtherVALU OPTIONS
NE84639OtherBC BS
NE5106OtherMIDLANDS CHOICE