Provider Demographics
NPI:1174826739
Name:CUMMINGS, PAULA (MA)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7136
Mailing Address - Country:US
Mailing Address - Phone:541-842-7799
Mailing Address - Fax:541-842-7798
Practice Address - Street 1:722 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:BUTTE FALLS
Practice Address - State:OR
Practice Address - Zip Code:97522
Practice Address - Country:US
Practice Address - Phone:541-842-7799
Practice Address - Fax:541-842-7798
Is Sole Proprietor?:No
Enumeration Date:2010-12-20
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORC4101101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health