Individual provider Active NPI

Lillie Koran Cunningham, LMFT

  • Marriage & Family Therapist
  • Macon, GA
National Provider Identifier
1023359171
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT001354 Issued in GA
Practice address
6601 Zebulon Rd
Macon, GA 31220-7606
Phone
(478) 477-3383
NPI assigned
Mar 13, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT001354 GA Primary

Addresses

Primary practice location

6601 Zebulon Rd
Macon, GA 31220-7606

Mailing address

521 Anderson Ave
Fort Valley, GA 31030-4140
Phone (478) 477-3383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFT001354GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hephzibah Childrens Home Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1023359171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 ANDERSON AVE",
            "city": "FORT VALLEY",
            "state": "GA",
            "postal_code": "310304140",
            "telephone_number": "478-477-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 ZEBULON RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312207606",
            "telephone_number": "478-477-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "LILLIE",
        "middle_name": "KORAN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-13",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.