Kent Wesley Cannon, PSY.D.
Individual provider Active NPI Clinical Psychologist · Lincoln, NE
NPI 1194581660 · NPPES record last updated Jul 23, 2025
Key facts
- NPI
- 1194581660
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 1046 (NE)
- Practice address
- 2300 S 16TH St
Lincoln, NE 68502-3704 - Phone
- (402) 481-5636
- NPI assigned
- Feb 22, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bryan Medical Center
Practice addresses (Care Compare)
2221 S 17TH St
201 Bryan Medical Center Counseling Center
Lincoln, NE 68502-3700
Phone (402) 481-5991
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240613003256 | NE | Practitioner - Clinical Psychologist | 0244773679 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bryan Medical Center | Current | Accepting new patients | |
| Bryan Medical Center | Current |
Accepting new patients | |
| Bryan Medical Center | Current |
Accepting new patients |
Locations
2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042
1600 S 48th St
Lincoln, NE 68506
Phone (402) 481-9049
2221 S 17th St
Ste 201
Lincoln, NE 68502
Phone (402) 481-5991
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1046 | NE | Yes |
Addresses
Primary practice location
2300 S 16TH St
Lincoln, NE 68502-3704
Mailing address
2300 S 16TH St
Lincoln, NE 68502-3704
Phone (402) 481-5636
Other providers in Lincoln, NE
- Cancer Partners of Nebraska PC
- Cancer Partners of Nebraska PC
- Candace Sam, LLC
- Danielle Kaylene Cannafax
- Elizabeth Canning
- Shuronda Raynect Cannon
- Susanna L Cantarero
- Monica Danielle Cantrell
- Loc Huu Cao
- Denise L Capek
All providers in Lincoln, NE · Clinical Psychologist in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.