Active NPI
Cannon Therapeutic
- Clinical Social Worker
- Midway, UT
National Provider Identifier
1497624951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- CANNON THERAPEUTIC
- Practice address
- 125 W Main St Unit 324
Midway, UT 84049-8014 - Phone
- (949) 244-9982
- NPI assigned
- Nov 3, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tucker Croxall Cannon, LCSW
- Title
- Owner, Provider
- Phone
- (949) 244-9982
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
125 W Main St Unit 324
Midway, UT 84049-8014
Mailing address
125 W Main St Unit 324
Midway, UT 84049-8014
Phone (949) 244-9982
National Provider Directory
National Provider DirectoryLocations
125 W Main St
Unit 324
Midway, UT 84049
Phone (949) 244-9982
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762128000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762128000000",
"number": "1497624951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 W MAIN ST UNIT 324",
"city": "MIDWAY",
"state": "UT",
"postal_code": "840498014",
"telephone_number": "949-244-9982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 W MAIN ST UNIT 324",
"city": "MIDWAY",
"state": "UT",
"postal_code": "840498014",
"telephone_number": "949-244-9982"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CANNON THERAPEUTIC",
"organizational_subpart": "NO",
"enumeration_date": "2025-11-03",
"last_updated": "2025-11-03",
"certification_date": "2025-11-03",
"status": "A",
"authorized_official_last_name": "CANNON",
"authorized_official_first_name": "TUCKER",
"authorized_official_middle_name": "CROXALL",
"authorized_official_title_or_position": "OWNER, PROVIDER",
"authorized_official_telephone_number": "949-244-9982",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midway, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.