Provider Demographics
NPI:1396208435
Name:CUMBERLAND COUNSELING, LLC
Entity Type:Organization
Organization Name:CUMBERLAND COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOMPELELO
Authorized Official - Middle Name:KHUMALO
Authorized Official - Last Name:BOUCHER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:617-791-2645
Mailing Address - Street 1:175 NATE WHIPPLE HWY
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-1416
Mailing Address - Country:US
Mailing Address - Phone:617-791-2645
Mailing Address - Fax:
Practice Address - Street 1:175 NATE WHIPPLE HWY
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-1416
Practice Address - Country:US
Practice Address - Phone:617-791-2645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-06
Last Update Date:2019-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty