Provider Demographics
NPI:1801922745
Name:CUNHA, GARY HERBERT (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:HERBERT
Last Name:CUNHA
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 RIVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-5636
Mailing Address - Country:US
Mailing Address - Phone:919-577-6079
Mailing Address - Fax:
Practice Address - Street 1:508 FULTON ST
Practice Address - Street 2:(116)
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-286-0411
Practice Address - Fax:919-416-5832
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0023141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical