MEDICARE: SHEKINAH CUMMINGS LCSW

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	SW21714	FL

General Provider Information

NPI Number	:	1417503434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEKINAH CUMMINGS LCSW

Provider Business Mailing Address
First Line	:	10140 CENTURION PKWY N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-0532
Country	:	US
Telephone Number	:	904-697-4100
Fax Number	:	904-697-5102

Provider Business Practice Location Address
First Line	:	1717 S ORANGE AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-2944
Country	:	US
Telephone Number	:	407-650-7000
Fax Number	:	407-567-5924

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

Provider Enumeration Date	:	08/15/2019
Last Update Date	:	01/13/2026

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