Wavely Roy Cunningham, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3560 Issued in LA

Practice address

1525 Stephens Ave
Shreveport, LA 71101-4705

Phone

(318) 221-6121

Fax

(318) 222-7879

NPI assigned

Jun 11, 2008

Last updated

Jun 11, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Samaritan Counseling Center

  • Mental Health Counselor
  • Shreveport, LA
  • NPI 1184780900
  NPD (past)

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1467612762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 STEPHENS AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014705",
            "telephone_number": "318-221-6121",
            "fax_number": "318-222-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 STEPHENS AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014705",
            "telephone_number": "318-221-6121",
            "fax_number": "318-222-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "WAVELY",
        "middle_name": "ROY",
        "name_prefix": "Ms.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "3560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "3560",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Cummings-Shelby, M.A.
• Lacoya Danielle Cummings, L.P.C.
• Cloud Ian Diaz Cunanan
• Jenessia L. Cunningham, LCSW
• Kimberle Mary Cunningham, LPC LMFT LAC
• Julie A Cupp, M.D.
• Stephanie S Currie, MS, CCC-SLP
• Douglas Curry Jr.
• Jasmine Curry
• Michael S Curry, LPC, NCC

• Mental Health Counselor in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Mental Health Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.