Kannon Elizabeth, LCSW, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CG60441194 Issued in WA

Practice address

6500 S Macadam Ave Ste 375
Portland, OR 97239-3566

Phone

(541) 357-9433

NPI assigned

Feb 21, 2014

Last updated

Jun 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/family-solutions/r4/

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.

• Insight Northwest Recovery

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Eugene, OR
  • NPI 1992411052
  NPD (past)
• Family Solutions, Inc

  • Community/Behavioral Health Agency
  • Vancouver, WA
  • NPI 1831258995
  NPD (past)

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

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1326463712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 S MACADAM AVE STE 375",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393566",
            "telephone_number": "541-357-9433",
            "fax_number": "541-603-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 S MACADAM AVE STE 375",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393566",
            "telephone_number": "541-357-9433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "436 SE 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972141323",
            "country_code": "US",
            "telephone_number": "503-305-3088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELIZABETH",
        "first_name": "KANNON",
        "credential": "LCSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-21",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LW60713264",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60441194",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "L7100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth a. Schmick DO LLC
• Elizabeth Busetto ND LLC (Rose Natural Health)
• Elizabeth Farrell, Pmhnp, LLC
• Elizabeth Nguyen, DC., LLC (Back 2 Health Chiropractic Clinic)
• Elizabeth Schuler DMD LLC (Rockwood Orthodontics)
• Lauri Elizabeth, LAC
• Erin Leigh Elizondo
• Elke K Herbrechtsmeier, DC
• Callia Kumiko Elkhal, MD
• Christopher Elkhal, DMD

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.