1437399110 NPI number — SARAH GILLESPIE CUMMINGS LMFT

Table of content: SARAH GILLESPIE CUMMINGS LMFT (NPI 1437399110)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437399110 NPI number — SARAH GILLESPIE CUMMINGS LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CUMMINGS
Provider First Name:
SARAH
Provider Middle Name:
GILLESPIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GILLESPIE
Provider Other First Name:
SARAH
Provider Other Middle Name:
LESLEY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMFT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437399110
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2600 SW 4TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT LAUDERDALE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33315-2610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-761-2641
Provider Business Mailing Address Fax Number:
954-761-2673

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 SW 4TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33315-2610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-761-2641
Provider Business Practice Location Address Fax Number:
954-761-2673
Provider Enumeration Date:
02/20/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MT1614 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)