Provider Demographics
NPI:1477561397
Name:CUMMINS-ALLEN, ELIZABETH H (LISW-S)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:H
Last Name:CUMMINS-ALLEN
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:H
Other - Last Name:CUMMINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:5516 STATE ROUTE 752
Mailing Address - Street 2:
Mailing Address - City:ASHVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43103-9549
Mailing Address - Country:US
Mailing Address - Phone:614-570-8635
Mailing Address - Fax:740-689-9518
Practice Address - Street 1:2670 N COLUMBUS ST STE D
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8408
Practice Address - Country:US
Practice Address - Phone:614-570-8635
Practice Address - Fax:740-689-9518
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0005835104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCUSW18441Medicare ID - Type Unspecified