Provider Demographics
NPI:1639760036
Name:CUNNINGHAM, BRIDGET A (MS, PLPC)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:A
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MS, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1944 E SUNSHINE ST STE D
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-1510
Mailing Address - Country:US
Mailing Address - Phone:417-501-6927
Mailing Address - Fax:
Practice Address - Street 1:1944 E SUNSHINE ST STE D
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1510
Practice Address - Country:US
Practice Address - Phone:417-501-6927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO202202329101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health