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NPI Code Detail

MEDICARE: CASSANDRA LEE CUMMINS MBS LPC

MEDICARE: CASSANDRA LEE CUMMINS MBS LPC
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
1101Y00000XCounselor3809OK

General Provider Information

NPI Number : 1275769937
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA LEE CUMMINS MBS LPC
Provider Business Mailing Address
First Line : 804 S BROADWAY ST
Second Line :
City : POTEAU
State : OK
Zip : 74953-3834
Country : US
Telephone Number : 918-647-9629
Fax Number : 918-649-0136
Provider Business Practice Location Address
First Line : 804 S BROADWAY ST
Second Line :
City : POTEAU
State : OK
Zip : 74953-3834
Country : US
Telephone Number : 918-647-9629
Fax Number : 918-649-0136
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2009
Last Update Date : 11/01/2023

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