Basic Information
| Provider Information | |||||||||
| NPI: | 1245470707 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CUNNINGHAM | ||||||||
| FirstName: | DONNA | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LPCC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CUNNINGHAM | ||||||||
| OtherFirstName: | DONNA | ||||||||
| OtherMiddleName: | D | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | LPCC-S | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6605 W CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436171000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4198417701 | ||||||||
| FaxNumber: | 4198411691 | ||||||||
| Practice Location | |||||||||
| Address1: | 6605 W CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436171000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4198417701 | ||||||||
| FaxNumber: | 4198411691 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2009 | ||||||||
| LastUpdateDate: | 11/23/2012 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | C.0501369 | OH | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | E.0501369 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.