Individual
SAMANTHA C CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10920 SW BARBUR BLVD, PORTLAND, OR 97219-8600
(541) 687-1110
Mailing address
10920 SW BARBUR BLVD, PORTLAND, OR 97219-8600
(541) 687-1110
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH60630652
WA
1041C0700X
Clinical Social Worker
Primary
L7991
OR
1041C0700X
Clinical Social Worker
LW61371985
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500717085
—
OR
Enumeration date
10/17/2016
Last updated
02/17/2026
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