Provider Demographics
NPI:1689947954
Name:CUMMINS, SHERRI J
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:J
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14505 FANCHER RD
Mailing Address - Street 2:JOHNSTOWN
Mailing Address - City:JOHNSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43031-8127
Mailing Address - Country:US
Mailing Address - Phone:740-975-4915
Mailing Address - Fax:186-684-5640
Practice Address - Street 1:370 W CHURCH ST
Practice Address - Street 2:JOHNSTOWN
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-4239
Practice Address - Country:US
Practice Address - Phone:740-975-4915
Practice Address - Fax:186-684-5640
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1000203101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional