Mary Alice Cunningham PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

323492-3501 Issued in UT

Legal business name

MARY ALICE CUNNINGHAM PC

Practice address

7971 Pioneer St
Midvale, UT 84047-7418

Phone

(801) 842-9800

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Mary Alice Stoddard Cunningham, LCSW

Title

Ceo

Phone

(801) 842-9800

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235284100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7971 PIONEER ST",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840477418",
            "telephone_number": "801-842-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7971 PIONEER ST",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840477418",
            "telephone_number": "801-842-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ALICE CUNNINGHAM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "MARY ALICE",
        "authorized_official_middle_name": "STODDARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-842-9800",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "323492-3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "1093742058",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Marler, CPO
• Abigail Marquez-Gonzalez, CSWI
• Stephen K Martin, O.D.
• Tina C. Martin, O.D.
• Katie Martindale, SUDC
• Kenneth John Marz, D.D.S.
• Judy Mason, RN
• James Matern, RPH
• Kristin Matheson
• Nicole Hazelton Matthews, M.ED, BCBA

• Clinical Social Worker in Midvale, UT
• Providers in Midvale, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.