Provider Demographics
NPI:1023024049
Name:REID-CUNNINGHAM, MAUREEN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:
Last Name:REID-CUNNINGHAM
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1731
Mailing Address - Country:US
Mailing Address - Phone:617-661-6177
Mailing Address - Fax:617-354-5344
Practice Address - Street 1:10 HARRINGTON RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1731
Practice Address - Country:US
Practice Address - Phone:617-233-1364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1016269-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1851811Medicaid
MAP04972OtherBCBS OF MA
MA1892878Medicaid
MA1892878Medicaid