Provider Demographics
NPI:1215183587
Name:CUMMINGS, COLLEEN MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:MARIE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 TOWER OAKS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4265
Mailing Address - Country:US
Mailing Address - Phone:301-593-6554
Mailing Address - Fax:
Practice Address - Street 1:3200 TOWER OAKS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4265
Practice Address - Country:US
Practice Address - Phone:301-593-6554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05514103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08258Medicaid