Provider Demographics
NPI:1881567220
Name:CUNNINGHAM, ELIZABETH MICHELLE
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MICHELLE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 LINNET LN
Mailing Address - Street 2:
Mailing Address - City:MAXWELL
Mailing Address - State:TX
Mailing Address - Zip Code:78656-2051
Mailing Address - Country:US
Mailing Address - Phone:512-748-3400
Mailing Address - Fax:
Practice Address - Street 1:129 LINNET LN
Practice Address - Street 2:
Practice Address - City:MAXWELL
Practice Address - State:TX
Practice Address - Zip Code:78656-2051
Practice Address - Country:US
Practice Address - Phone:512-748-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92556101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health