Provider Demographics
NPI:1366793390
Name:CUMMINS, KARIN ADDIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KARIN
Middle Name:ADDIE
Last Name:CUMMINS
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 1:8765 WILD ROSE LN
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:UT
Mailing Address - Zip Code:84331-8924
Mailing Address - Country:US
Mailing Address - Phone:435-525-7464
Mailing Address - Fax:
Practice Address - Street 1:8765 WILD ROSE LN
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:UT
Practice Address - Zip Code:84331-8924
Practice Address - Country:US
Practice Address - Phone:435-279-0402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7763855-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical