Provider Demographics
NPI:1871371575
Name:CUMMINGS, LISA SHEILA I (LMSW)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:SHEILA
Last Name:CUMMINGS
Suffix:I
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 MELROSE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5757
Mailing Address - Country:US
Mailing Address - Phone:917-473-6996
Mailing Address - Fax:718-504-4551
Practice Address - Street 1:860 MELROSE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5757
Practice Address - Country:US
Practice Address - Phone:917-473-6996
Practice Address - Fax:718-504-4551
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108899104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker