Provider Demographics
NPI:1841697604
Name:CUNNINGHAM, SAMANTHA CHRISTINE (LMHC, LPC)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:CHRISTINE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:LMHC, LPC
Other - Prefix:MS
Other - First Name:SAMANTHA
Other - Middle Name:CHRISTINE
Other - Last Name:GOODWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:2 S 56TH PL STE 201D
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-3427
Mailing Address - Country:US
Mailing Address - Phone:340-342-4863
Mailing Address - Fax:
Practice Address - Street 1:2 S 56TH PL STE 201D
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642-3427
Practice Address - Country:US
Practice Address - Phone:360-342-4863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-21
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60508150101YM0800X, 106H00000X
WAL60630652101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist