Provider Demographics
NPI:1811237399
Name:CUNNINGHAM, ANNE CALLAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:CALLAN
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8238 WILLIAM WALLACE DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27358-9331
Mailing Address - Country:US
Mailing Address - Phone:336-908-1843
Mailing Address - Fax:336-275-9522
Practice Address - Street 1:8238 WILLIAM WALLACE DR
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:NC
Practice Address - Zip Code:27358-9331
Practice Address - Country:US
Practice Address - Phone:336-908-1843
Practice Address - Fax:336-275-9522
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0081821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical