Individual provider Active NPI

Stephanie Joy Cunningham, PHD

  • Counseling Psychologist
  • Indianapolis, IN
National Provider Identifier
1972189595
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
20042766A Issued in IN
Practice address
1120 West Michigan Street, Gatch Hall Suite 600
Indiana University School of Medicine
Indianapolis, IN 46202
Phone
(317) 278-4751
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 20042766A IN Primary

Addresses

Primary practice location

1120 West Michigan Street, Gatch Hall Suite 600
Indiana University School of Medicine
Indianapolis, IN 46202

Mailing address

6308 Long River LN
Indianapolis, IN 46221-4253
Phone (513) 328-6214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240627001245 OH Practitioner - Clinical Psychologist 6103360474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

1260 Independence Ave
Akron, OH 44310-1812
Phone (234) 312-2111

525 E Market St
Akron, OH 44304-1619

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20042766AINMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Summa Physicians LLC Current Accepting new patients
Summa Physicians LLC CurrentSince Jul 8, 2024 Accepting new patients
Summa Physicians LLC CurrentSince Jul 8, 2024 Accepting new patients

Locations

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

Organizations & group practices 3

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1972189595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 LONG RIVER LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462214253",
            "telephone_number": "513-328-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 WEST MICHIGAN STREET, GATCH HALL SUITE 600",
            "address_2": "INDIANA UNIVERSITY SCHOOL OF MEDICINE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46202",
            "telephone_number": "317-278-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "STEPHANIE",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IN",
            "license": "20042766A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.