Provider Demographics
NPI:1821514878
Name:CUMMING, ANGELA (LPC, MAC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:CUMMING
Suffix:
Gender:F
Credentials:LPC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 E 7TH ST STE 207
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-2676
Mailing Address - Country:US
Mailing Address - Phone:541-296-5452
Mailing Address - Fax:541-296-1537
Practice Address - Street 1:419 E 7TH ST STE 207
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-2676
Practice Address - Country:US
Practice Address - Phone:541-296-5452
Practice Address - Fax:541-296-1537
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5617101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health