Provider Demographics
NPI:1174363675
Name:CUMMINGS BRANDENBURG COUNSELING PLLC
Entity type:Organization
Organization Name:CUMMINGS BRANDENBURG COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:CUMMINGS
Authorized Official - Last Name:BRANDENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:704-255-4529
Mailing Address - Street 1:16607 RIVERSTONE WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-5750
Mailing Address - Country:US
Mailing Address - Phone:704-255-4529
Mailing Address - Fax:
Practice Address - Street 1:16607 RIVERSTONE WAY STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-5750
Practice Address - Country:US
Practice Address - Phone:704-439-6583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-31
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)