Active NPI
Jackie Dee Cunningham, LPC, LMFT
- Professional Counselor
- Waco, TX
National Provider Identifier
1093722571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 9087
- Practice address
- 6801 Sanger Ave
Ste 201
Waco, TX 76710-7818 - Phone
- (254) 741-1737
- Fax
- (254) 741-1737
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 917 | TX | |
| Professional Counselor | 101YP2500X | 9087 | TX | Primary |
Addresses
Primary practice location
6801 Sanger Ave
Ste 201
Waco, TX 76710-7818
Mailing address
8208 Teakwood Dr
Waco, TX 76712-2426
Phone (254) 772-2780
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6159LC | Other | TX | BLUE CROSS BLUE SHIELD |
| 156153201 | Medicaid | TX | |
| 72716400 | Other | TX | MAGELLAN HEALTH |
| 526067 | Other | TX | VALUE OPTIONS |
| 290089568 | Other | TX | UNITED BEHAVIORAL HEALTH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9087 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675641600000",
"number": "1093722571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8208 TEAKWOOD DR",
"city": "WACO",
"state": "TX",
"postal_code": "767122426",
"telephone_number": "254-772-2780",
"fax_number": "254-741-1496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6801 SANGER AVE",
"address_2": "STE 201",
"city": "WACO",
"state": "TX",
"postal_code": "767107818",
"telephone_number": "254-741-1737",
"fax_number": "254-741-1737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "JACKIE",
"middle_name": "DEE",
"name_prefix": "Mrs.",
"credential": "LPC, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2023-02-06",
"certification_date": "2023-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "917",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "9087",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "6159LC",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "156153201",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN HEALTH",
"identifier": "72716400",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "526067",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "290089568",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.