Cunningham, Jackie Dee

Cunningham, Jackie Dee is an sole proprietor health care provider with primary practice located at 6801 Sanger Ave Ste 201, Waco TX 76710-7818. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Cunningham, Jackie Dee can be contacted via phone (254) 741-1737.

Contact Information

Primary practice address
6801 Sanger Ave Ste 201 Waco TX 76710-7818
Phone: (254) 741-1737
Fax: (254) 741-1737
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 917 Texas
Behavioral Health & Social Service Providers / Professional 101YP2500X 9087 Texas

Profile Details

NPI number 1093722571
LBN Legal business name Cunningham, Jackie Dee
Credentials LPC, LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 1st, 2006
Last updated Feb 6th, 2023 - about last year

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 1093722571 NPPES
Texas Other 6159LC BLUE CROSS BLUE SHIELD
Texas MEDICAID 156153201 BLUE CROSS BLUE SHIELD
Texas Other 72716400 BLUE CROSS BLUE SHIELD
Texas Other 526067 BLUE CROSS BLUE SHIELD
Texas Other 290089568 BLUE CROSS BLUE SHIELD

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