Individual
KENNETH CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW - INTERN
Contact information
Practice address
3371 N BUFFALO DR, LAS VEGAS, NV 89129
(702) 515-1373
Mailing address
3321 N BUFFALO DR, SUITE 200, LAS VEGAS, NV 89129
(702) 868-5800
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
IC1352
NV
101YM0800X
Mental Health Counselor
IC1352
NV
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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