Provider Demographics
NPI:1235193996
Name:CUMMINGS, NICOLE KAY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:KAY
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4195 TAMIAMI TRL S PMB #126
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-5112
Mailing Address - Country:US
Mailing Address - Phone:941-497-2244
Mailing Address - Fax:941-497-2244
Practice Address - Street 1:4195 TAMIAMI TRL S PMB #126
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-5112
Practice Address - Country:US
Practice Address - Phone:941-497-2244
Practice Address - Fax:941-497-2244
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW78301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical