MEDICARE: MRS. ANA MARIA DANIELA CUNNINGHAM LCSW

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1780350322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANA MARIA DANIELA CUNNINGHAM LCSW

Provider Business Mailing Address
First Line	:	902 BLUFFS CT
Second Line	:
City	:	PETOSKEY
State	:	MI
Zip	:	49770-8570
Country	:	US
Telephone Number	:	248-974-5660
Fax Number	:

Provider Business Practice Location Address
First Line	:	3890 CHARLEVOIX RD STE 306
Second Line	:
City	:	PETOSKEY
State	:	MI
Zip	:	49770-8423
Country	:	US
Telephone Number	:	248-974-5660
Fax Number	:	231-881-9132

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2021
Last Update Date	:	03/02/2024

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