Provider Demographics
NPI:1992508923
Name:CUMMINGS, KENLI FAYE
Entity type:Individual
Prefix:
First Name:KENLI
Middle Name:FAYE
Last Name:CUMMINGS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 SEALY CT
Mailing Address - Street 2:
Mailing Address - City:GATESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76528-2621
Mailing Address - Country:US
Mailing Address - Phone:254-248-2930
Mailing Address - Fax:
Practice Address - Street 1:2201 MACARTHUR DR STE 100
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-3159
Practice Address - Country:US
Practice Address - Phone:254-202-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker