Provider Demographics
NPI:1447068150
Name:LUMPKIN, ORSHUM
Entity type:Individual
Prefix:
First Name:ORSHUM
Middle Name:
Last Name:LUMPKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 COLGATE AVE APT 5D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-4827
Mailing Address - Country:US
Mailing Address - Phone:347-623-0920
Mailing Address - Fax:
Practice Address - Street 1:820 COLGATE AVE APT 5D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-4827
Practice Address - Country:US
Practice Address - Phone:347-623-0920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP127252101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor