Healthcare Provider Details
I. General information
NPI: 1023085651
Provider Name (Legal Business Name): MERCIA F CUMMINGS LCPC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/02/2006
Last Update Date: 04/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
603 POST OFFICE ROAD
WALDORF MD
20602
US
IV. Provider business mailing address
P.O. BOX 820
WHITE PLAINS MD
20695
US
V. Phone/Fax
- Phone: 301-758-5992
- Fax: 301-203-0522
- Phone: 301-758-5992
- Fax: 301-203-0522
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | LC2055 |
| License Number State | MD |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | PRC13915 |
| License Number State | DC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: