Provider Demographics
NPI:1780694265
Name:CUMMINGS, HILLEARY (MED, MA, LCPC, LPCC)
Entity type:Individual
Prefix:
First Name:HILLEARY
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:MED, MA, LCPC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 SARATOGA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-3411
Mailing Address - Country:US
Mailing Address - Phone:312-952-9450
Mailing Address - Fax:
Practice Address - Street 1:960 SARATOGA AVE STE 110
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-3411
Practice Address - Country:US
Practice Address - Phone:408-634-2682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.005998101YM0800X, 101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional