Active NPI
Jenny Sue Cunningham, LCMHC
- Mental Health Counselor
- Winooski, VT
National Provider Identifier
1295894459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 068-0000465
- Practice address
- 20 W Canal St
Suite C2
Winooski, VT 05404-2131 - Phone
- (802) 654-7600
- Fax
- (802) 654-7601
- NPI assigned
- Dec 6, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 068-0000465 | VT | Primary |
Addresses
Primary practice location
20 W Canal St
Suite C2
Winooski, VT 05404-2131
Mailing address
20 W Canal St
Suite C2
Winooski, VT 05404-2131
Phone (802) 654-7600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1008198 | Medicaid | VT | |
| 58344 | Other | VT | PROVIDER NUMBER |
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 |
|---|---|---|---|
| 068-0000465 | VT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Shirley Oxidine, PLLC | 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.
-
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- Middlebury, VT
- NPI 1508192584
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1295894459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 W CANAL ST",
"address_2": "SUITE C2",
"city": "WINOOSKI",
"state": "VT",
"postal_code": "054042131",
"telephone_number": "802-654-7600",
"fax_number": "802-654-7601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 W CANAL ST",
"address_2": "SUITE C2",
"city": "WINOOSKI",
"state": "VT",
"postal_code": "054042131",
"telephone_number": "802-654-7600",
"fax_number": "802-654-7601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "JENNY",
"middle_name": "SUE",
"credential": "LCMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "068-0000465",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1008198",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER NUMBER",
"identifier": "58344",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winooski, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.