Provider Demographics
NPI:1013533272
Name:CUMMINGS, KAREN (RBT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 COUNTRY LIVING CIR
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:FL
Mailing Address - Zip Code:32666-4046
Mailing Address - Country:US
Mailing Address - Phone:904-452-3449
Mailing Address - Fax:
Practice Address - Street 1:219 COUNTRY LIVING CIR
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:FL
Practice Address - Zip Code:32666-4046
Practice Address - Country:US
Practice Address - Phone:904-452-3449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1013533272Medicaid