Provider Demographics
NPI:1598849960
Name:CUNNINGHAM, PATRICIA MELODY (LCPC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MELODY
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 COMMERCE CT STE 300-9
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3709
Mailing Address - Country:US
Mailing Address - Phone:630-247-4418
Mailing Address - Fax:
Practice Address - Street 1:4300 COMMERCE CT
Practice Address - Street 2:SUITE 310
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532
Practice Address - Country:US
Practice Address - Phone:630-544-3324
Practice Address - Fax:630-544-3325
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-003155101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health