Individual
WAYNE KIERAN CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.M.H.C., L.A.D.C.
Contact information
Practice address
2760 MAIN STREET, EASTERN SLOPE INN, NORTH CONWAY, NH 03860
(603) 356-9955
Mailing address
PO BOX 476, NORTH CONWAY, NH 03860-0476
(603) 356-9955
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0331
NH
101YM0800X
Mental Health Counselor
Primary
237
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30014439
—
NH
Enumeration date
03/07/2007
Last updated
10/04/2007
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