Individual provider Active NPI

Lauren Lisa Cunningham, PHD

  • Clinical Psychologist
  • Madison, WI
National Provider Identifier
1457458184
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2301-057 Issued in WI
Practice address
1619 Monroe St
Madison, WI 53711-2063
Phone
(608) 255-9330
Fax
(608) 255-7810
NPI assigned
Sep 17, 2006
Last updated
Jul 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2301-057 WI Primary

Addresses

Primary practice location

1619 Monroe St
Madison, WI 53711-2063

Mailing address

1619 Monroe St
Madison, WI 53711-2063
Phone (608) 255-9330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090219000476 WI Practitioner - Clinical Psychologist 9537224878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integral Psychology CenterGroup PAC ID 7810092996, 5 clinicians

Practice addresses (Care Compare)

1619 Monroe St
Madison, WI 53711-2063
Phone (608) 255-9330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2301-057WIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integral Psychology Center CurrentSince Jan 21, 2009 Accepting new patients

Locations

1619 Monroe St
Madison, WI 53711
Phone (608) 225-2341

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1457458184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 MONROE ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112063",
            "telephone_number": "608-255-9330",
            "fax_number": "608-255-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 MONROE ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112063",
            "telephone_number": "608-255-9330",
            "fax_number": "608-255-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "LAUREN",
        "middle_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2301-057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.