Provider Demographics
NPI:1336475045
Name:CUNNINGHAM, MONA (LPC)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3736 DEESE RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGER
Mailing Address - State:OK
Mailing Address - Zip Code:73458-8076
Mailing Address - Country:US
Mailing Address - Phone:580-222-7156
Mailing Address - Fax:
Practice Address - Street 1:301 W MAIN ST STE 324
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-6322
Practice Address - Country:US
Practice Address - Phone:580-222-7156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-30
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional