Individual provider Active NPI

John Roy Cannon, LPCMH

  • Mental Health Counselor
  • Newark, DE
National Provider Identifier
1487618211
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4331 Issued in DE
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

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2248072OtherDECIGNA BEHAVIORAL HEALTH
1000036893OtherDEDE MED. ASSIST. PROGRAM
254526OtherDECOMPSYCH
364878OtherDEMHN/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

LicenseStateTypeSpecialty
112DEMDAddiction (Substance Use Disorder) Counselor
4331DEMDMental Health Counselor
PC-0000008DEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.