Provider Demographics
NPI:1235810375
Name:CUMMINGS, CAROLE (LSW)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 JOHNSON RD STE 7
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-1777
Mailing Address - Country:US
Mailing Address - Phone:856-863-3913
Mailing Address - Fax:
Practice Address - Street 1:129 JOHNSON RD STE 7
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-1777
Practice Address - Country:US
Practice Address - Phone:856-863-3913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06641900104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker