Provider Demographics
NPI:1417922659
Name:CUMMINGS, DOROTHY MERWIN (LCSW)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:MERWIN
Last Name:CUMMINGS
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:RR 203 BOX 707
Mailing Address - Street 2:
Mailing Address - City:NORTH CHATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12132-0707
Mailing Address - Country:US
Mailing Address - Phone:518-766-2768
Mailing Address - Fax:518-766-7008
Practice Address - Street 1:RR 203 4279
Practice Address - Street 2:
Practice Address - City:NORTH CHATHAM
Practice Address - State:NY
Practice Address - Zip Code:12132-0707
Practice Address - Country:US
Practice Address - Phone:518-766-2768
Practice Address - Fax:518-766-7008
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03438911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000405492001OtherBLUE SHIELD OF NE NY
NY131895OtherVALUE OPTIONS
NYN54721Medicare ID - Type Unspecified