Cunningham, Channon M

Cunningham, Channon M is an individual health care provider with primary practice located at 460 Market St Ste 114, Williamsport PA 17701-6321. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Cunningham, Channon M can be contacted via phone (570) 212-9481.

Contact Information

Primary practice address
460 Market St Ste 114 Williamsport PA 17701-6321
Phone: (570) 212-9481
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Clinical 1041C0700X CW014860 Pennsylvania

Profile Details

NPI number 1023096856
LBN Legal business name Cunningham, Channon M
Credentials MSW, LCSW, CAC/CCDP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2006
Last updated Oct 27th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023096856 NPPES
Pennsylvania Other 1362328 BLUE CROSS/BLUE SHIELD

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