Provider Demographics
NPI:1154197622
Name:CUNNINGHAM, LAURYN ELIZABETH (PLPC)
Entity type:Individual
Prefix:
First Name:LAURYN
Middle Name:ELIZABETH
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 N MAIN ST FL 3
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-3466
Mailing Address - Country:US
Mailing Address - Phone:601-724-3628
Mailing Address - Fax:
Practice Address - Street 1:623 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-3466
Practice Address - Country:US
Practice Address - Phone:601-724-3628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP-1019101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor