Individual
KRESA MAUDE CUMMINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD,MSW,LCSW,LCAS
Contact information
Practice address
106 MCCABE ST, MAXTON, NC 28364-1760
(910) 844-1187
Mailing address
2569 UNION CHAPEL RD, PEMBROKE, NC 28372-8263
(910) 733-3614
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-30938
NC
1041C0700X
Clinical Social Worker
P023133
NC
Other
Enumeration date
12/11/2023
Last updated
11/01/2025
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