Provider Demographics
NPI:1619445608
Name:CUNNINGHAM, JEANNA (CMHC)
Entity type:Individual
Prefix:
First Name:JEANNA
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 S PLEASANT GROVE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-2878
Mailing Address - Country:US
Mailing Address - Phone:801-410-0542
Mailing Address - Fax:
Practice Address - Street 1:233 S PLEASANT GROVE BLVD STE 201
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-2878
Practice Address - Country:US
Practice Address - Phone:801-410-0542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7932424-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health