Provider Demographics
NPI:1033785043
Name:CUNNINGHAM, WINIFRED H (MSW, LSW, LCADC)
Entity Type:Individual
Prefix:MRS
First Name:WINIFRED
Middle Name:H
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MSW, LSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111B GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-1734
Mailing Address - Country:US
Mailing Address - Phone:973-980-1137
Mailing Address - Fax:
Practice Address - Street 1:6 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5241
Practice Address - Country:US
Practice Address - Phone:201-880-7530
Practice Address - Fax:201-880-7529
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSWGTL2001945104100000X
NJ37LC00330100101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker