Provider Demographics
NPI:1588870463
Name:CUNNINGHAM, MEG ELIZABETH (P-LCSW)
Entity type:Individual
Prefix:MRS
First Name:MEG
Middle Name:ELIZABETH
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:P-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6704 RIVA RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-5787
Mailing Address - Country:US
Mailing Address - Phone:801-597-8336
Mailing Address - Fax:
Practice Address - Street 1:7621 LITTLE AVE
Practice Address - Street 2:SUITE 420
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-8162
Practice Address - Country:US
Practice Address - Phone:704-541-5626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0038701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical