Provider Demographics
NPI:1073820692
Name:CUNNINGHAM, TONYA HART (LPC)
Entity type:Individual
Prefix:MS
First Name:TONYA
Middle Name:HART
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2879 HIGHWAY 160 W STE 4388
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8581
Mailing Address - Country:US
Mailing Address - Phone:803-526-3288
Mailing Address - Fax:
Practice Address - Street 1:2135 QUINN RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:SC
Practice Address - Zip Code:29706-6163
Practice Address - Country:US
Practice Address - Phone:803-526-3288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101Y00000X101Y00000X
SC103K00000X103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst