Individual provider Active NPI

Candace Cunningham, LMHC

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1700538212
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
013115 Issued in NY
Practice address
15 Macdonough St Ste 3B
Brooklyn, NY 11216-2303
Phone
(347) 475-1676
NPI assigned
Jan 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 106006-01 NY
Mental Health Counselor 101YM0800X 013115 NY Primary

Addresses

Primary practice location

15 Macdonough St Ste 3B
Brooklyn, NY 11216-2303

Mailing address

418 Broadway Ste N
Albany, NY 12207-2922
Phone (816) 269-0145

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

LicenseStateTypeSpecialty
106006-01NYMDMental Health Counselor
013115NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Candace Cunningham Mental Health Counseling PLLC Mental Health Current Accepting new patients
SG Wellness MHC PLLC Mental Health CurrentSince Jul 24, 2022 Accepting new patients

Locations

418 Broadway
Ste N
Albany, NY 12207
Phone (201) 278-8966

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1700538212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 BROADWAY STE N",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072922",
            "telephone_number": "816-269-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MACDONOUGH ST STE 3B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162303",
            "telephone_number": "347-475-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "CANDACE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "106006-01",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "013115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.