Provider Demographics
NPI:1710317185
Name:CUMMINGS, CHANDRA (LPC)
Entity Type:Individual
Prefix:
First Name:CHANDRA
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9103 TIFFANY CREST CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-6695
Mailing Address - Country:US
Mailing Address - Phone:602-410-4325
Mailing Address - Fax:
Practice Address - Street 1:9103 TIFFANY CREST CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-6695
Practice Address - Country:US
Practice Address - Phone:602-410-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-20
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLPC-2021045859101YP2500X
VALPC-0701006840101YP2500X
AZLPC-14130101YP2500X
NCLCMHC-17320101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional