Provider Demographics
NPI:1508606641
Name:CUMINALE, AMANDA KAY (LCSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:KAY
Last Name:CUMINALE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:64683-0030
Mailing Address - Country:US
Mailing Address - Phone:660-359-4487
Mailing Address - Fax:660-359-2958
Practice Address - Street 1:401 YOUSSEF DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601-1643
Practice Address - Country:US
Practice Address - Phone:660-359-4487
Practice Address - Fax:660-359-2958
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024013653104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker