Provider Demographics
NPI:1336358167
Name:CUNNINGHAM-CALLAGHAN, MARSHA (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:CUNNINGHAM-CALLAGHAN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:MARSI
Other - Middle Name:
Other - Last Name:CALLAGHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:395 TUNXIS AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-1119
Mailing Address - Country:US
Mailing Address - Phone:860-906-1883
Mailing Address - Fax:
Practice Address - Street 1:395 TUNXIS AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-1119
Practice Address - Country:US
Practice Address - Phone:860-906-1883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000626106H00000X
MA1082106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist