Provider Demographics
NPI:1316991342
Name:CUMMINGS, LUCINDA (PHD)
Entity type:Individual
Prefix:DR
First Name:LUCINDA
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8085 WAYZATA BLVD
Mailing Address - Street 2:#212
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1453
Mailing Address - Country:US
Mailing Address - Phone:763-546-1796
Mailing Address - Fax:763-546-8264
Practice Address - Street 1:8085 WAYZATA BLVD
Practice Address - Street 2:#212
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1453
Practice Address - Country:US
Practice Address - Phone:763-546-1796
Practice Address - Fax:763-546-8260
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNLP2102103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN43P88CUOtherBLUE CROSS BLUE SHIELD
MN5550521Medicaid