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NPI Code Detail

MEDICARE: LESLIE CUNNINGHAM MA, LPC

MEDICARE: LESLIE CUNNINGHAM MA, LPC
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
1101YM0800XMental Health CounselorC5070658MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15743627OTHERAETNA
219914011OTHERMOBLUE SHIELD KC,MO

General Provider Information

NPI Number : 1821145566
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE CUNNINGHAM MA, LPC
Provider Business Mailing Address
First Line : 5775 NW 64TH TER
Second Line : SUITE 201
City : KANSAS CITY
State : MO
Zip : 64151-2382
Country : US
Telephone Number : 913-248-9693
Fax Number : 913-248-9383
Provider Business Practice Location Address
First Line : 5775 NW 64TH TER
Second Line : SUITE 201
City : KANSAS CITY
State : MO
Zip : 64151-2382
Country : US
Telephone Number : 816-746-5352
Fax Number : 816-746-5254
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 07/08/2007

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