Provider Demographics
NPI:1942536776
Name:CUMMINGS, KAREN G
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:G
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MCCOY RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-4937
Mailing Address - Country:US
Mailing Address - Phone:304-529-6205
Mailing Address - Fax:304-529-6209
Practice Address - Street 1:2001 MCCOY RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-4937
Practice Address - Country:US
Practice Address - Phone:304-529-6205
Practice Address - Fax:304-529-6209
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2609103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool