Cathlyn Carole Cannon, L.P.C. MHSP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

001551 Issued in TN

Practice address

114 E Unaka Ave
Johnson City, TN 37601-4624

Phone

(865) 241-1408

NPI assigned

Mar 29, 2007

Last updated

Nov 27, 2023By 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 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TN

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

Interoperability endpoints

• Direct secure messaging: lifestancehealth.cathlyncannon@148560.advancedmd-direct.com

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.

• Healthy Mind Counseling Services, Inc

  • Clinical Social Worker
  • Knoxville, TN
  • NPI 1457409898
  Medicare reassignment NPD

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1952420895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 SINKING CREEK RD APT 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376047822",
            "telephone_number": "423-418-2400",
            "fax_number": "423-282-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E UNAKA AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014624",
            "telephone_number": "865-241-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "CATHLYN",
        "middle_name": "CAROLE",
        "name_prefix": "Ms.",
        "credential": "L.P.C. MHSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "LPC 00511",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "LPC 5511",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "001551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508371",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS COMMERCIAL",
            "identifier": "4078991",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECARE/TENNCARE",
            "identifier": "2500701",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALTH",
            "identifier": "59932800",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Campbell, RBT
• Makensey Campbell, DDS
• Nelea Dotson Campbell, MSN, APRN, FNP-C
• Cancer Outreach Associates of Tennessee, P.C.
• Benjamin Chad Cannon, CPRS
• Elizabeth Forgey Cannon, DDS
• Jennifer Leigh Cannon, FNP
• Brittany M Cantrell, P.A.
• McKayla Cantrell, CCC-SLP
• Peggy Joyce Cantrell

• Professional Counselor in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.