MEDICARE: MS. JOAN FAYE CUMMINGS LCSW-R

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R034390	NY

General Provider Information

NPI Number	:	1013909639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOAN FAYE CUMMINGS LCSW-R

Provider Business Mailing Address
First Line	:	132 ALBANY ST
Second Line	:	ATWELL MILLS ANNEX
City	:	CAZENOVIA
State	:	NY
Zip	:	13035-1231
Country	:	US
Telephone Number	:	315-729-3491
Fax Number	:	607-863-3926

Provider Business Practice Location Address
First Line	:	132 ALBANY ST
Second Line	:	ATWELL MILLS ANNEX
City	:	CAZENOVIA
State	:	NY
Zip	:	13035-1231
Country	:	US
Telephone Number	:	315-729-3491
Fax Number	:	607-863-3926

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	12/26/2012

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