Healthcare Provider Details

I. General information

NPI: 1518381979
Provider Name (Legal Business Name): TELKO ADAMS CUNNINGHAM CAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2014
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 W WALTON AVE
MUSKEGON MI
49440-1360
US

IV. Provider business mailing address

1934 E APPLE AVE # 206
MUSKEGON MI
49442-4247
US

V. Phone/Fax

Practice location:
  • Phone: 231-674-9084
  • Fax: 231-728-1456
Mailing address:
  • Phone: 231-674-9064
  • Fax: 231-728-1456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801091313
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: