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General NPI Number Information
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NPI Number | 1356592869
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Entity Type | Individual
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Provider Name | LAURIE A CUNNINGHAM MED, PCC
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Gender | Female
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 02/28/2018
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Provider Practice Location Address
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Address Line | 915 S RIVERSIDE DR
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City | MCCONNELSVILLE
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State | OH
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Zip | 43756-0506
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Country | US
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Telephone | 740-454-9766
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Fax | 740-588-6452
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Provider Business Mailing Address
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Address Line | 2845 BELL ST
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City | ZANESVILLE
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State | OH
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Zip | 43701-1720
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Country | US
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Telephone | 740-454-9766
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Fax | 740-588-6452
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C0602138
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C0602138
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E0602138
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License Number State | OH
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