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General NPI Number Information
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NPI Number | 1457827826
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Entity Type | Individual
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Provider Name | JAYLEE CUNNINGHAM MA, LMFT
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Gender | Female
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Dates
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Enumeration Date | 10/23/2018
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 169 E REYNOLDS RD STE 101
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City | LEXINGTON
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State | KY
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Zip | 40517-1270
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Country | US
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Telephone | 859-279-2949
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Fax | 502-323-0749
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Provider Business Mailing Address
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Address Line | 169 E REYNOLDS RD STE 100A
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City | LEXINGTON
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State | KY
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Zip | 40517-1272
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Country | US
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Telephone | 859-279-2949
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Fax | 502-323-0749
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 273964
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License Number State | KY
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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 | 273964
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License Number State | KY
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