Provider Demographics
NPI:1659314730
Name:CUNNINGHAM, DENNIS (LCPC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 HOSPITAL DR
Mailing Address - Street 2:SUITE G-03
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3110
Mailing Address - Country:US
Mailing Address - Phone:301-856-6000
Mailing Address - Fax:301-856-8938
Practice Address - Street 1:10401 HOSPITAL DR
Practice Address - Street 2:SUITE G-03
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3110
Practice Address - Country:US
Practice Address - Phone:301-856-6000
Practice Address - Fax:301-856-8938
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0134101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLC0134OtherSTATE LICENSE