Provider Demographics
NPI:1912522640
Name:CAROL CUMMINGS COUNSELING LLC
Entity type:Organization
Organization Name:CAROL CUMMINGS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW, LCAC
Authorized Official - Phone:316-882-7251
Mailing Address - Street 1:200 W DOUGLAS AVE STE 701
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-3013
Mailing Address - Country:US
Mailing Address - Phone:316-882-7251
Mailing Address - Fax:
Practice Address - Street 1:200 W DOUGLAS AVE STE 701
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-3013
Practice Address - Country:US
Practice Address - Phone:316-882-7251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS2310OtherLICENSED SPECIALIST CLINICAL SOCIAL WORK
KS200303060CMedicaid
KS434OtherLICENSED CLINICAL ADDICTION COUNSELOR