Provider Demographics
NPI:1184045593
Name:CUMMINGS, TIFFANY ANGELIC (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:ANGELIC
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TIFFANY
Other - Middle Name:ANGELIC
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6416 PIMA PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-2594
Mailing Address - Country:US
Mailing Address - Phone:505-519-4956
Mailing Address - Fax:
Practice Address - Street 1:1501 SAN PEDRO DR SE # BHCL116
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-5153
Practice Address - Country:US
Practice Address - Phone:505-265-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-02
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-103091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical