Individual provider Active NPI

Mark R Cunningham, MFT-C

  • Marriage & Family Therapist
  • Fort Collins, CO
National Provider Identifier
1174125165
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFTC.0013774 Issued in CO
Practice address
2625 Redwing Rd Unit 175 Office 1
Fort Collins, CO 80526
Phone
(970) 825-3848
NPI assigned
Nov 13, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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 MFTC.0013774 CO Primary

Addresses

Primary practice location

2625 Redwing Rd Unit 175 Office 1
Fort Collins, CO 80526

Mailing address

1531 W Swallow Rd Apt 36
Fort Collins, CO 80526-2397
Phone (702) 885-6473

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
MFTC.0013774COMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1174125165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 W SWALLOW RD APT 36",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262397",
            "telephone_number": "702-885-6473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 REDWING RD UNIT 175 OFFICE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80526",
            "telephone_number": "970-825-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "MFT-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "MFTC.0013774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.