Provider Demographics
NPI:1538898408
Name:CUMMINGS, TYLOR (MA, LMFT)
Entity type:Individual
Prefix:
First Name:TYLOR
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:TYLOR
Other - Middle Name:
Other - Last Name:BEARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:411 3RD ST N
Mailing Address - Street 2:
Mailing Address - City:WAITE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:56387-1177
Mailing Address - Country:US
Mailing Address - Phone:320-230-0611
Mailing Address - Fax:
Practice Address - Street 1:411 3RD ST N
Practice Address - Street 2:
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387-1177
Practice Address - Country:US
Practice Address - Phone:320-230-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4158101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional