DESERI ALICIA CUNNINGHAM


Address: 230 N Belcrest Ave Ste A, Springfield, MO 65802-6287
Phone: 4174134676

DESERI ALICIA CUNNINGHAM (NPI# 1356757900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356757900
Entity Type Individual
Full Name DESERI ALICIA CUNNINGHAM
Other Name DESERI ALICIA JOHNSON
Credential PSYD, LP
Practice Address 230 N Belcrest Ave Ste A
Springfield
MO 65802-6287
Mailing Address 1300 E Bradford Pkwy
Springfield
MO 65804-4264
Practice Telephone 4174134676
Practice Fax Number 4177633308
Mailing Telephone 4177615000
Mailing Fax Number 4177615011
Enumeration Date 2014-07-03
Last Update Date 2019-03-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101YM0800X Counselor
Specialization: Mental Health
2014022296 MO Behavioral Health & Social Service Providers
Y 103TC0700X Psychologist
Specialization: Clinical
2016035950 MO Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MO 490014993 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
1300 E Bradford Pkwy, Springfield, MO 65804 4177615000 4177615011
230 N Belcrest Ave Ste A, Springfield, MO 658026287 4174134676 4177633308
864 E Hwy 60, Monett, MO 657089376 4175974309 4177633308

Office Location

Street Address 230 N BELCREST AVE STE A
City SPRINGFIELD
State MO
Zip Code 65802-6287

Providers in the same location

NPI Name Taxonomy Address Enumeration
1518963172 Susan E. Pyle Psychologist 230 N Belcrest Ave Ste A, Springfield, MO 65802-6287 2005-06-28
1285135509 Jessica Katherine Hintz Huff Counselor 230 N Belcrest Ave Ste A, Springfield, MO 65802-6287 2018-02-22
1891213096 Molly Kay Six Counselor 230 N Belcrest Ave Ste A, Springfield, MO 65802-6287 2017-09-07
1679005136 Jessica Lynne Mcdonald Counselor 230 N Belcrest Ave Ste A, Springfield, MO 65802-6287 2017-04-03
1861940843 Alisyn L Van Note Counselor 230 N Belcrest Ave Ste A, Springfield, MO 65802-6287 2016-09-19
1033519350 Lauren A Golden Psychologist 230 N Belcrest Ave Ste A, Springfield, MO 65802-6287 2014-08-25
1902232028 Melissa Gibson Counselor 230 N Belcrest Ave Ste A, Springfield, MO 65802-6287 2013-09-20
1558640615 Whitney Jean Stilley Psychologist 230 N Belcrest Ave Ste A, Springfield, MO 65802-6287 2011-08-08
1902107378 Ginger D Crabtree Behavioral Analyst 230 N Belcrest Ave Ste A, Springfield, MO 65802-6287 2010-11-16
1316039001 Jennifer Ann Bartlett Counselor 230 N Belcrest Ave Ste A, Springfield, MO 65802-6287 2006-09-29
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1407454549 Andrea Strauch Counselor 2024 W Chestnut Expressway Way, Springfield, MO 65802 2020-10-12
1962968867 Chad Michael Linck Specialist/Technologist 2125 N Glenstone Ave, Springfield, MO 65802 2019-02-15
1790254647 Meds To Live By Pharmacist 1134 N. Scarlett Way, Springfield, MO 65802 2018-11-21
1568945103 Ficom Non-Pharmacy Dispensing Site 1308 North Glenstone Avenue, Springfield, MO 65802 2018-09-10
1982194775 Karla Caballero Marriage & Family Therapist 8627 Montant Fort Way, 145, Sprinfield, MO 65802 2018-05-16
1780191809 Tiffany Chawntay Coryell Pharmacist 1134 North Scarlett Way, Springfield, MO 65802 2018-01-10
1083134902 Trevor Conner Family Medicine 1423 N Jefferson Ave, B100, Springfield, MO 65802 2017-06-21
1407389596 Medical Mile Imaging Radiology 3905 E Windsmore Dr, Springfield, MO 65802 2017-04-06
1346619103 Jill A Knight Occupational Therapist 1601 E. Pythian, Green Valley State School, Springfield, MO 65802 2015-09-22
1447653258 Wal-mart Stores East Lp Durable Medical Equipment & Medical Supplies 3720 E Sunshine St, Springfield, MO 65802 2014-10-07
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

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1194359216 Kathrin A Koehler Psychologist 4674 Hominy Ridge Rd, Springfield, OH 45502-8031 2020-02-27
1689126120 Assessment Consultants, LLC Psychologist 2146 W Chesterfield Blvd Ste E202, Springfield, MO 65807-8650 2016-11-01
1003366436 Caitriona Hayes Psychologist 8134 Old Keene Mill Road, Suite 101, Springfield, VA 22152 2016-10-10
1669929907 Richart Lipe Demier Psychologist 5871 S Northern Ridge Rd, Springfield, MO 65810-1976 2016-09-03
1043660905 Safe Harbor Christian Counseling of Northern Virginia LLC Psychologist 8304 Old Keene Mill Rd, Springfield, VA 22152-1640 2016-06-21
1659786432 Kimberly Wilkins Psyd LLC Psychologist 1344 W Oakville Rd, Springfield, MO 65810-1696 2014-06-30
1548507817 Bahn and Associates Psychologist 3000 Professional Dr Ste D, Bahn Consulting, Inc., Springfield, IL 62703-5931 2013-01-07
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Competitor

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City SPRINGFIELD
Zip Code 65802

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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