Healthcare Provider Details

I. General information

NPI: 1932046042
Provider Name (Legal Business Name): KIRSTEN CUMMINGS CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 PROSPECTOR AVE STE 202
PARK CITY UT
84060-7223
US

IV. Provider business mailing address

7000 N GREENFIELD DR
PARK CITY UT
84098-5899
US

V. Phone/Fax

Practice location:
  • Phone: 310-560-1998
  • Fax:
Mailing address:
  • Phone: 310-560-1998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9881101-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: