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General NPI Number Information
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NPI Number | 1245581180
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Entity Type | Organization
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Legal Business Name | CUNNINGHAM COUNSELING ASSOCIATES L.L.C.
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Dates
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Enumeration Date | 10/01/2012
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Last Update Date | 12/14/2012
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Provider Practice Location Address
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Address Line | 20525 DETROIT RD SUITE 6
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City | ROCKY RIVER
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State | OH
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Zip | 44116-2444
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Country | US
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Telephone | 216-767-5709
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Fax |
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Provider Business Mailing Address
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Address Line | 20525 DETROIT RD SUITE 6
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City | ROCKY RIVER
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State | OH
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Zip | 44116-2444
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Country | US
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Telephone | 216-767-5709
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KELLY ELIZABETH CUNNINGHAM
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Credential | LISWS, LICDC
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Telephone | 440-409-5486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I 0008301
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License Number State | OH
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