Provider Demographics
NPI:1679656854
Name:CUNNINGHAM, JANET (LPC)
Entity Type:Individual
Prefix:
First Name:JANET
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 1:84 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6047
Mailing Address - Country:US
Mailing Address - Phone:209-792-0400
Mailing Address - Fax:203-794-9556
Practice Address - Street 1:84 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6047
Practice Address - Country:US
Practice Address - Phone:209-792-0400
Practice Address - Fax:203-794-9556
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000988101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional