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Individual
MRS. JACKIE DEE CUNNINGHAM
Active
Individual
MRS. JACKIE DEE CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
9087
TX
106H00000X
Marriage & Family Therapist
917
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156153201
—
TX
01
—
290089568
UNITED BEHAVIORAL HEALTH
TX
01
—
526067
VALUE OPTIONS
TX
01
—
6159LC
BLUE CROSS BLUE SHIELD
TX
01
—
72716400
MAGELLAN HEALTH
TX
Enumeration date
08/01/2006
Last updated
02/06/2023
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