Provider Demographics
NPI:1346300084
Name:CUMMING, BARBARA J (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:CUMMING
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 1:74 WINTHROP ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-5544
Mailing Address - Country:US
Mailing Address - Phone:207-622-2673
Mailing Address - Fax:207-622-2673
Practice Address - Street 1:74 WINTHROP ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5544
Practice Address - Country:US
Practice Address - Phone:207-622-2673
Practice Address - Fax:207-622-2673
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2015-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC38661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MM8247Medicare PIN