Active NPI
Nancy A Cannon, LCSW, LMHP, CEAP
- Clinical Social Worker
- Omaha, NE
National Provider Identifier
1104464890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 813
- Practice address
- 11605 Arbor St Ste 106
Omaha, NE 68144-2982 - Phone
- (402) 330-4700
- Fax
- (402) 330-8815
- NPI assigned
- Dec 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 813 | NE | Primary |
Addresses
Primary practice location
11605 Arbor St Ste 106
Omaha, NE 68144-2982
Mailing address
16305 Decatur Cir
Omaha, NE 68118-2418
Phone (402) 660-8047
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 813 | NE | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cannon Counseling LLC | Single Specialty | Current | Accepting new patients |
Organizations & group practices 1
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": "1576195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576195200000",
"number": "1104464890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16305 DECATUR CIR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681182418",
"telephone_number": "402-660-8047",
"fax_number": "402-330-8815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11605 ARBOR ST STE 106",
"city": "OMAHA",
"state": "NE",
"postal_code": "681442982",
"telephone_number": "402-330-4700",
"fax_number": "402-330-8815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNON",
"first_name": "NANCY",
"middle_name": "A",
"credential": "LCSW, LMHP, CEAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-13",
"last_updated": "2019-12-13",
"certification_date": "2019-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "NE",
"license": "813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.