Individual provider Active NPI

Matthew David Cunningham, LLMSW

  • Social Worker
  • Ann Arbor, MI
National Provider Identifier
1992165633
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801094111 Issued in MI
Practice address
110 N 4TH Ave
Ann Arbor, MI 48104-5503
Phone
(734) 544-3000
Fax
(734) 544-6716
NPI assigned
Feb 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801094111 MI Primary

Addresses

Primary practice location

110 N 4TH Ave
Ann Arbor, MI 48104-5503

Mailing address

555 Towner St
Ypsilanti, MI 48198-5752
Phone (734) 544-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20211223000121 MI Practitioner - Clinical Social Worker 5991196180 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peaceful Mind Counseling Services LLCGroup PAC ID 9739437138, 15 clinicians

Practice addresses (Care Compare)

2820 Baker Rd
Suite 100
Dexter, MI 48130-1196
Phone (734) 580-2920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation CurrentSince Jan 1, 2024 Accepting new patients
Chelsea Community Hospital CurrentSince Dec 1, 2021 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Peaceful Mind Counseling Services LLC CurrentSince Jun 5, 2024 Accepting new patients
Chelsea Community Hospital CurrentSince Dec 1, 2021 Accepting new patients
Iha Health Service Corporation CurrentSince Jan 1, 2024 Accepting new patients
County of Washtenaw PastSince Jul 8, 2019 Accepting new patients
Sasco Dexter LLC PastSince Jun 5, 2024 Accepting new patients
County of Washtenaw Past Accepting new patients

Locations

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

2820 Baker Rd
Ste 100
Dexter, MI 48130
Phone (734) 580-2920

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

Organizations & group practices 9

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": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1992165633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 TOWNER ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985752",
            "telephone_number": "734-544-3000",
            "fax_number": "734-544-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N 4TH AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045503",
            "telephone_number": "734-544-3000",
            "fax_number": "734-544-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801094111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.