Kristi B Cannon, PH.D., LPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

61756 Issued in TX

Practice address

4611 Bee Cave Rd
Suite 105
West Lake Hills, TX 78746-5220

Phone

(512) 329-5004

Fax

(512) 329-5904

NPI assigned

Jan 12, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1447520044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 BEE CAVE RD",
            "address_2": "SUITE 105",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465220",
            "telephone_number": "512-329-5004",
            "fax_number": "512-329-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 BEE CAVE RD",
            "address_2": "SUITE 105",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465220",
            "telephone_number": "512-329-5004",
            "fax_number": "512-329-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "KRISTI",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "61756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Robert Caridi, M.D.
• Heather Ellen Carrillo, LPC
• Jarod Benjamin Carter, DPT

• All providers in West Lake Hills, TX
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.