=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225840911
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KIANA CUMMINGS LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/21/2025
-----------------------------------------------------
Last Update Date | 01/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7980 STATE ROUTE 12
-----------------------------------------------------
City | BARNEVELD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13304-2536
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-624-8563
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 111 HOSPITAL DR
-----------------------------------------------------
City | UTICA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13502-2517
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-801-8534
-----------------------------------------------------
Fax | 315-801-8391
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------