Provider Demographics
NPI:1326512690
Name:CUMMINGS, JESSICA LYNN (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LYNN
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:GANGWES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:318 CHANDLER ST SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-7469
Mailing Address - Country:US
Mailing Address - Phone:636-293-0138
Mailing Address - Fax:
Practice Address - Street 1:318 CHANDLER ST SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-7469
Practice Address - Country:US
Practice Address - Phone:636-293-0138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-19
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20160403041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical