Provider Demographics
NPI:1710503149
Name:CUMMINS COUNSELING LLC
Entity Type:Organization
Organization Name:CUMMINS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:JENNIFER
Authorized Official - Last Name:CUMMINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:609-373-2378
Mailing Address - Street 1:717 CARDINAL WAY
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-3102
Mailing Address - Country:US
Mailing Address - Phone:609-373-2378
Mailing Address - Fax:
Practice Address - Street 1:536 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1213
Practice Address - Country:US
Practice Address - Phone:609-373-2378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1649741505OtherNPPES