Active NPI
John Roy Cannon, LPCMH
- Mental Health Counselor
- Newark, DE
National Provider Identifier
1487618211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4331
- Practice address
- 117 Larkspur Rd
Newark, DE 19711-6863 - Phone
- (302) 738-9963
- Fax
- (302) 995-2121
- NPI assigned
- Apr 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 112 | DE | |
| Mental Health Counselor | 101YM0800X | 4331 | DE | Primary |
| Professional Counselor | 101YP2500X | PC-0000008 | DE |
Addresses
Primary practice location
117 Larkspur Rd
Newark, DE 19711-6863
Mailing address
117 Larkspur Rd
Newark, DE 19711-6863
Phone (302) 738-9963
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2248072 | Other | DE | CIGNA BEHAVIORAL HEALTH |
| 1000036893 | Other | DE | DE MED. ASSIST. PROGRAM |
| 254526 | Other | DE | COMPSYCH |
| 364878 | Other | DE | MHN/TRICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112 | DE | MD | Addiction (Substance Use Disorder) Counselor |
| 4331 | DE | MD | Mental Health Counselor |
| PC-0000008 | DE | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counseling Resource Associates, Inc. | Addiction (Substance Use Disorder) | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Counselor
- Newark, DE
- NPI 1942350145
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1487618211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 LARKSPUR RD",
"city": "NEWARK",
"state": "DE",
"postal_code": "197116863",
"telephone_number": "302-738-9963",
"fax_number": "302-995-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 LARKSPUR RD",
"city": "NEWARK",
"state": "DE",
"postal_code": "197116863",
"telephone_number": "302-738-9963",
"fax_number": "302-995-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNON",
"first_name": "JOHN",
"middle_name": "ROY",
"credential": "LPCMH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "DE",
"license": "112",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "DE",
"license": "4331",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "DE",
"license": "PC-0000008",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "2248072",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DE MED. ASSIST. PROGRAM",
"identifier": "1000036893",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPSYCH",
"identifier": "254526",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN/TRICARE",
"identifier": "364878",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.