Healthcare Provider Details

I. General information

NPI: 1134787393
Provider Name (Legal Business Name): HALEY J CUMMINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HALEY MCCOY

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3880 CLIME RD
COLUMBUS OH
43228-3532
US

IV. Provider business mailing address

3880 CLIME RD
COLUMBUS OH
43228-3532
US

V. Phone/Fax

Practice location:
  • Phone: 740-507-0606
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberI.2204084
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberI.2204084
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: