Individual
JASON CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC, LICDC
Contact information
Practice address
2115 W PARK DR, LORAIN, OH 44053-1138
(440) 989-4987
(440) 282-4779
Mailing address
2115 W PARK DR, LORAIN, OH 44053-1138
(440) 989-4900
(440) 282-4779
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1312443
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.162045
OH
101YM0800X
Mental Health Counselor
C.2003043
OH
101YM0800X
Mental Health Counselor
Primary
E.2303364
OH
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0383469
—
OH
Enumeration date
02/26/2016
Last updated
05/02/2023
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