Provider Demographics
NPI:1588320766
Name:CUNNINGHAM, LOMIE (LSW)
Entity type:Individual
Prefix:
First Name:LOMIE
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 PROSPECT AVE APT 8G
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2614
Mailing Address - Country:US
Mailing Address - Phone:201-450-6277
Mailing Address - Fax:
Practice Address - Street 1:7 GLENWOOD AVE STE 406
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-1065
Practice Address - Country:US
Practice Address - Phone:973-666-2678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health