Organization
CUNNINGHAM COUNSELING ASSOCIATES L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY ELIZABETH CUNNINGHAM LISWS, LICDC (OWNER)
(440) 409-5486
Entity
Organization
Contact information
Practice address
20525 DETROIT RD, SUITE 6, ROCKY RIVER, OH 44116-2444
(216) 767-5709
Mailing address
20525 DETROIT RD, SUITE 6, ROCKY RIVER, OH 44116-2444
(216) 767-5709
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I 0008301
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW35811
MEDICARE PTAN
—
Enumeration date
10/01/2012
Last updated
12/14/2012
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