Healthcare Provider Details

I. General information

NPI: 1902459027
Provider Name (Legal Business Name): KRISTIN CUMMINGS LMHC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 S CURRY PIKE
BLOOMINGTON IN
47403-3170
US

IV. Provider business mailing address

764 S DEER RUN
ELLETTSVILLE IN
47429-2039
US

V. Phone/Fax

Practice location:
  • Phone: 812-606-9026
  • Fax: 812-610-2323
Mailing address:
  • Phone: 812-606-9026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39002976A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: