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NPI Code Detail

MEDICARE: MRS. AMANDA L.. CUMMINGS LCSW

MEDICARE: MRS. AMANDA L.. CUMMINGS LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerC005300NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1142JMOTHERNCBCBS NUMBER
2C005300OTHERNCLICENSE NUMBER

General Provider Information

NPI Number : 1134150485
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA L.. CUMMINGS LCSW
Provider Business Mailing Address
First Line : 4094 HWY 710 N
Second Line :
City : PEMBROKE
State : NC
Zip : 28372
Country : US
Telephone Number : 910-671-3453
Fax Number : 910-671-3484
Provider Business Practice Location Address
First Line : 460 COUNTRY CLUB RD
Second Line :
City : LUMBERTON
State : NC
Zip : 28360-9494
Country : US
Telephone Number : 910-671-3453
Fax Number : 910-671-3484
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 10/02/2012

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