Provider Demographics
NPI:1518381979
Name:ADAMS CUNNINGHAM, TELKO (CAADC)
Entity type:Individual
Prefix:
First Name:TELKO
Middle Name:
Last Name:ADAMS CUNNINGHAM
Suffix:
Gender:F
Credentials:CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1934 E APPLE AVE # 206
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-4247
Mailing Address - Country:US
Mailing Address - Phone:231-674-9064
Mailing Address - Fax:231-728-1456
Practice Address - Street 1:8 W WALTON AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49440-1360
Practice Address - Country:US
Practice Address - Phone:231-674-9084
Practice Address - Fax:231-728-1456
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010913131041C0700X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical