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NPI Code Detail

MEDICARE: LAURA ANN B. CUNNINGHAM LISW

MEDICARE: LAURA ANN B. CUNNINGHAM LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI.10265OH

General Provider Information

NPI Number : 1598783391
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA ANN B. CUNNINGHAM LISW
Provider Business Mailing Address
First Line : 2525 E 22ND ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-3202
Country : US
Telephone Number : 216-459-9827
Fax Number : 216-696-5638
Provider Business Practice Location Address
First Line : 3518 W 25TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1951
Country : US
Telephone Number : 216-459-9827
Fax Number : 216-459-9821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 04/15/2008

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