Kimberlee Lockwood Cannon, LISW-CP

Primary specialty

Social WorkerTaxonomy code 104100000X

License

11700 Issued in SC

Practice address

2711 Colonial Dr
Columbia, SC 29203-6818

Phone

(803) 726-9460

NPI assigned

Jun 3, 2016

Last updated

Jun 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kimberlee Allen Lockwood Former name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lexington Richland Alcohol & Drug Abuse Council, Inc.

  dba Lradac

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Columbia, SC
  • NPI 1538153069
  Medicare reassignment NPD
• Lexington Richland Alcohol & Drug Abuse Council, Inc.

  dba Lradac

  • Addiction Medicine (Family Medicine) Physician
  • Columbia, SC
  • NPI 1437924438
  NPD (past)

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1538517248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036818",
            "telephone_number": "803-726-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "KIMBERLEE",
        "middle_name": "LOCKWOOD",
        "credential": "LISW-CP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "11700",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLEE",
            "last_name": "LOCKWOOD",
            "middle_name": "ALLEN",
            "credential": "LISW-CP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charles Bruce Cannon, M.ED., LPC
• Christine Connor Cannon, NP
• Constance Cannon
• James Daniel Cannon
• Jessica A Cannon, ANP
• Wayne M Cannon, O.D.
• Jessica Rowena Cantarutti, CRNA
• Nicole Cantor
• Laurie Anne Cantrell, N.P.
• Matthew G Cantrell, M.D.

• Social Worker in Columbia, SC
• Providers in Columbia, SC by specialty
• Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.