Provider Demographics
NPI:1235277534
Name:KUMMER, NANCY E (MSSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:E
Last Name:KUMMER
Suffix:
Gender:F
Credentials:MSSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2906
Mailing Address - Country:US
Mailing Address - Phone:781-449-2453
Mailing Address - Fax:781-449-4540
Practice Address - Street 1:44 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2906
Practice Address - Country:US
Practice Address - Phone:781-449-2453
Practice Address - Fax:781-449-4540
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1007221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP01719Medicare ID - Type Unspecified