Healthcare Provider Details

I. General information

NPI: 1649193186
Provider Name (Legal Business Name): HALEY RAE CUMMINGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5936 70TH AVE APT A4
RIDGEWOOD NY
11385-5604
US

IV. Provider business mailing address

5936 70TH AVE APT A4
RIDGEWOOD NY
11385-5604
US

V. Phone/Fax

Practice location:
  • Phone: 404-314-7222
  • Fax:
Mailing address:
  • Phone: 404-314-7222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberP144763
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: