Individual
JACOB JOHN CONNOR CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LIMHP
Contact information
Practice address
706 N 129TH ST STE 110, OMAHA, NE 68154-6116
(402) 980-6285
Mailing address
706 N 129TH ST STE 110, OMAHA, NE 68154-6116
(402) 980-6285
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
3522
NE
101YM0800X
Mental Health Counselor
12875
NE
101YM0800X
Mental Health Counselor
Primary
3522
NE
Other
Enumeration date
01/28/2022
Last updated
03/13/2024
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