Individual
KRISTEN CUMMINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
17 SUSSEX ST, PORT JERVIS, NY 12771-2430
(845) 856-6344
Mailing address
38 HOMESTEAD LN, OTISVILLE, NY 10963-2106
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
104457
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104457
LMSW
NY
Enumeration date
03/11/2019
Last updated
03/11/2019
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