Provider Demographics
NPI:1558554485
Name:CUMMINS, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:CUMMINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 IRIS AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2235
Mailing Address - Country:US
Mailing Address - Phone:720-565-0763
Mailing Address - Fax:
Practice Address - Street 1:6500 S QUEBEC ST STE 200
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4673
Practice Address - Country:US
Practice Address - Phone:303-221-0106
Practice Address - Fax:303-221-0107
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor