Provider Demographics
NPI:1811612369
Name:CUNNINGHAM, DANIEL (CDC-A, QBHS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:CDC-A, QBHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MADISON AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1257
Mailing Address - Country:US
Mailing Address - Phone:567-312-8700
Mailing Address - Fax:
Practice Address - Street 1:500 MADISON AVE STE 300
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-1257
Practice Address - Country:US
Practice Address - Phone:567-312-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health