Healthcare Provider Details

I. General information

NPI: 1275381337
Provider Name (Legal Business Name): ELLIE CUNNINGHAM LCMHC-A, LCAS-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 DOCTORS PARK STE G
ASHEVILLE NC
28801-4521
US

IV. Provider business mailing address

119 TUNNEL RD
ASHEVILLE NC
28805-1869
US

V. Phone/Fax

Practice location:
  • Phone: 828-251-1478
  • Fax:
Mailing address:
  • Phone: 704-737-0036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number27837
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA19908
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: