Provider Demographics
NPI:1790509404
Name:CUNNINGHAM, STARNIKA
Entity type:Individual
Prefix:
First Name:STARNIKA
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 N WESTOVER BLVD APT 1325
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-1938
Mailing Address - Country:US
Mailing Address - Phone:678-255-6198
Mailing Address - Fax:
Practice Address - Street 1:1120 W BROAD AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-4397
Practice Address - Country:US
Practice Address - Phone:229-903-1151
Practice Address - Fax:229-901-1149
Is Sole Proprietor?:No
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional