MEDICARE: MS. SADIE D CUMINGS 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
1	101Y00000X	Counselor	5790	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1881675502	OTHER	TX	FACILITY NPI NUMBER

General Provider Information

NPI Number	:	1548550536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SADIE D CUMINGS LPC

Provider Business Mailing Address
First Line	:	117 LANE DR
Second Line	:	SUITE 20
City	:	ROSENBERG
State	:	TX
Zip	:	77471-2200
Country	:	US
Telephone Number	:	281-238-0303
Fax Number	:	281-238-0371

Provider Business Practice Location Address
First Line	:	117 LANE DR
Second Line	:	SUITE 20
City	:	ROSENBERG
State	:	TX
Zip	:	77471-2200
Country	:	US
Telephone Number	:	281-238-0303
Fax Number	:	281-238-0371

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

Provider Enumeration Date	:	04/12/2011
Last Update Date	:	04/12/2011

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