Samantha Cannon, MSW

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3015 E Skelly Dr
Ste. 103
Tulsa, OK 74105-6317

Phone

(918) 712-0859

NPI assigned

Nov 6, 2013

Last updated

Nov 6, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reverence Counseling & Consulting

  • Clinical Social Worker
  • Tulsa, OK
  • NPI 1346874203
  Medicare reassignment NPD Authorized official
• Integrated Therapy Solutions of Oklahoma, LLC

  • Community/Behavioral Health Agency
  • Moore, OK
  • NPI 1659855278
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1063841419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 E SKELLY DR",
            "address_2": "STE. 103",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741056317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 E SKELLY DR",
            "address_2": "STE. 103",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741056317",
            "telephone_number": "918-712-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "SAMANTHA",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-06",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100746170G",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Cannon, LCSW
• Kathleen Sue Cannon, D.D.S.
• Michael Todd Cannon, DO
• Misty Dawn Cannon, NP
• Nicole Marie Cannon
• Christine E Canoe
• Karim Canto
• Chelsey Cantrell
• Jenny Cantrell
• Madison Leigh Cantrell

• Counselor in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.