Kevin Cannella, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPCC.0016287 Issued in CO

Practice address

3050 Broadway St
Boulder, CO 80304-3154

Phone

(410) 913-5989

NPI assigned

Nov 5, 2018

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1578031852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 SPRUCE ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803024626",
            "telephone_number": "410-913-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043154",
            "telephone_number": "410-913-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNELLA",
        "first_name": "KEVIN",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-05",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0016287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Canfield, M.A.
• Sarah E. Canfield, LCSW, CACII
• Jamie Noelle Canino
• Caelen Cann, M.A.
• Jason Andrew Cannell, DO
• Chris Cannon, MA, CAS
• Jennifer Cannon
• Laura Elise Pierce Cannon, PMHNP, LPC, CAC II
• Mark Smith Cannon, D.M.D.
• Regina Cannon, REGISTERED PSYCHOTHE

• Mental Health Counselor in Boulder, CO
• Providers in Boulder, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; 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.