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NPI Code Detail

MEDICARE: JESSICA CUNNINGHAM

MEDICARE: JESSICA CUNNINGHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorPROFESSIONALLICENSE

General Provider Information

NPI Number : 1982078234
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA CUNNINGHAM
Provider Business Mailing Address
First Line : 3587 HEATHROW WAY
Second Line :
City : MEDFORD
State : OR
Zip : 97504-4004
Country : US
Telephone Number : 541-858-8170
Fax Number :
Provider Business Practice Location Address
First Line : 1675 ASHLAND ST
Second Line :
City : ASHLAND
State : OR
Zip : 97520-2472
Country : US
Telephone Number : 541-505-8426
Fax Number : 541-515-6938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2015
Last Update Date : 02/06/2023

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Directions to “ JESSICA CUNNINGHAM ” Practice Location

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