Provider Demographics
NPI:1811192008
Name:CUMMING, MARY S (EDD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:S
Last Name:CUMMING
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 S OAK ST APT 201
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-1754
Mailing Address - Country:US
Mailing Address - Phone:864-654-0322
Mailing Address - Fax:
Practice Address - Street 1:1011 TIGER BLVD
Practice Address - Street 2:SUITE 610
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-2915
Practice Address - Country:US
Practice Address - Phone:864-654-0322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional