Provider Demographics
NPI:1245651595
Name:CUMMINGS, KATHY E (LCAS, CCS)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:E
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:LCAS, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1023 FAIRFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-6607
Mailing Address - Country:US
Mailing Address - Phone:910-223-7114
Mailing Address - Fax:910-672-7953
Practice Address - Street 1:803 STAMPER RD STE G
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4193
Practice Address - Country:US
Practice Address - Phone:910-223-7114
Practice Address - Fax:910-672-7953
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-03
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)