Christopher Canon, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

KY-00837 Issued in KY

Practice address

2084 Main St
Willisburg, KY 40078-8199

Phone

(859) 375-9200

Fax

(859) 375-9202

NPI assigned

Feb 9, 2015

Last updated

Feb 9, 2015By the provider in NPPES

Sex

Male

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)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1457742769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 GLENS CREEK RD",
            "city": "WILLISBURG",
            "state": "KY",
            "postal_code": "400788168",
            "telephone_number": "859-797-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2084 MAIN ST",
            "city": "WILLISBURG",
            "state": "KY",
            "postal_code": "400788199",
            "telephone_number": "859-375-9200",
            "fax_number": "859-375-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANON",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "KY-00837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelynn Raechelle Adams, RBT
• Angela Benz
• Calli Morgan Cox
• Joseph Michael Cox, LPCC
• Cumberland Family Medical Center, Inc. (North Washington Healthy Kids Clinic)
• Michael Dow, CADC
• Flaget Healthcare Inc (Flaget Primary Care Associates Willisburg RHC)

• Clinical Psychologist in Willisburg, KY
• Providers in Willisburg, KY by specialty
• Clinical Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.