Individual provider Active NPI

Michael Joseph Cunningham, CDC I

  • Addiction (Substance Use Disorder) Counselor
  • Anchorage, AK
National Provider Identifier
1629620489
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
2600 Cordova St Ste 101
Anchorage, AK 99503-2745
Phone
(907) 279-9634
NPI assigned
Jul 11, 2019
Sex
Male
Sole proprietor
No

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

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

NPPES NPI Registry

Primary practice location

2600 Cordova St Ste 101
Anchorage, AK 99503-2745

Mailing address

2600 Cordova St Ste 101
Anchorage, AK 99503-2745
Phone (907) 279-9634

Other practice location 1

8012 Stewart Mountain Dr
Eagle River, AK 99577-9013
Phone (907) 694-3336

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 6, 2020.

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1629620489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 CORDOVA ST STE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032745",
            "telephone_number": "907-279-9634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 CORDOVA ST STE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032745",
            "telephone_number": "907-279-9634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8012 Stewart Mountain Dr",
            "address_purpose": "LOCATION",
            "city": "Eagle River",
            "state": "AK",
            "postal_code": "995779013",
            "country_code": "US",
            "telephone_number": "907-694-3336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "CDC I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-11",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.