Provider Demographics
NPI:1760562326
Name:CUMMINGS-BRIDGE, ANNE M (LCSW LMFT LCDC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:CUMMINGS-BRIDGE
Suffix:
Gender:F
Credentials:LCSW LMFT LCDC
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:M
Other - Last Name:CUMMINGS-BRIDGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW LMFT LCDC
Mailing Address - Street 1:PO BOX 585
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76098-0585
Mailing Address - Country:US
Mailing Address - Phone:817-872-2663
Mailing Address - Fax:817-989-1329
Practice Address - Street 1:6914 CAMP BOWIE BLVD
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-7117
Practice Address - Country:US
Practice Address - Phone:817-872-2663
Practice Address - Fax:817-989-1329
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6569101YA0400X
TX116561041C0700X
TX2134106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist