Healthcare Provider Details

I. General information

NPI: 1881400976
Provider Name (Legal Business Name): KAREN CUNNINGHAM THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 E 87TH AVE STE 202
ANCHORAGE AK
99515-1935
US

IV. Provider business mailing address

331 E 87TH AVE STE 202
ANCHORAGE AK
99515-1935
US

V. Phone/Fax

Practice location:
  • Phone: 907-727-7253
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KAREN MAREE CUNNINGHAM
Title or Position: PRESIDENT
Credential: LMFT-S
Phone: 907-727-7253