Provider Demographics
NPI:1194825869
Name:CUMMINGS, LAURA CAROL (LSCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:CAROL
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:CUMMINGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSCSW
Mailing Address - Street 1:200 W DOUGLAS AVE STE 701
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-3013
Mailing Address - Country:US
Mailing Address - Phone:316-882-7251
Mailing Address - Fax:
Practice Address - Street 1:200 W DOUGLAS AVE STE 701
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-3013
Practice Address - Country:US
Practice Address - Phone:316-882-7251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS434101YA0400X
KS23101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS069738OtherMEDICARE
KS200303060AMedicaid