Angelyn M Cannon, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

P118079 Issued in NY

Practice address

3704 91St St
Jackson Heights, NY 11372-7914

Phone

(347) 730-4249

NPI assigned

Nov 21, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1245949072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8611 JAMAICA AVE FL 2",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114212043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 91ST ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727914",
            "telephone_number": "347-730-4249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10814 72nd Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113755301",
            "country_code": "US",
            "telephone_number": "347-392-4482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANNON",
        "first_name": "ANGELYN",
        "middle_name": "M",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "P118079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acannon@mindstogetherpc.net",
            "affiliation": "Y",
            "endpointDescription": "Work email",
            "affiliationName": "Minds Together LCSW PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3704 91st St",
            "city": "Jackson Heights",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113727914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Social Worker in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.