Active NPI
Brian Cunningham, CASAC-T
- Addiction (Substance Use Disorder) Psychologist
- Bay Shore, NY
National Provider Identifier
1942742952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Psychologist
- License
- 31718
- Practice address
- 1444 5TH Ave
Bay Shore, NY 11706-4147 - Phone
- (631) 647-3113
- NPI assigned
- Nov 8, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 31718 | NY | Primary |
Addresses
Primary practice location
1444 5TH Ave
Bay Shore, NY 11706-4147
Mailing address
76 Church Ave
Islip, NY 11751-3902
Phone (631) 449-0892
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 |
|---|---|---|---|
| 31718 | NY | MD | Addiction (Substance Use Disorder) Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478563200000",
"number": "1942742952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "76 CHURCH AVE",
"city": "ISLIP",
"state": "NY",
"postal_code": "117513902",
"telephone_number": "631-449-0892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1444 5TH AVE",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117064147",
"telephone_number": "631-647-3113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "BRIAN",
"credential": "CASAC-T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-11-08",
"last_updated": "2016-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "31718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bay Shore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.