Individual provider Active NPI

Andrea Jean Canny, LICSW

  • Clinical Social Worker
  • Manchester, NH
National Provider Identifier
1780170910
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1685 Issued in NH
Practice address
925 Mammoth Rd
Manchester, NH 03104-4508
Phone
(603) 540-7527
NPI assigned
Jul 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1685 NH Primary

Addresses

Primary practice location

925 Mammoth Rd
Manchester, NH 03104-4508

Mailing address

925 Mammoth Rd
Manchester, NH 03104-4508
Phone (603) 540-7527

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
1685NHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1780170910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 MAMMOTH RD",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031044508",
            "telephone_number": "603-540-7527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 MAMMOTH RD",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031044508",
            "telephone_number": "603-540-7527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNY",
        "first_name": "ANDREA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.