Brenda Jean Cannon, MS, NCC, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC #1214 Issued in WY

Practice address

1317 Boswell Dr
Laramie, WY 82070-5453

Phone

(307) 851-9736

Fax

(307) 742-6702

NPI assigned

Jun 4, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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

• Alliance for Growth

  • Professional Counselor
  • Laramie, WY
  • NPI 1760653596
  NPD (past)

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1962638908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 N 3RD ST",
            "address_2": "SUITE B1",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722544",
            "telephone_number": "307-742-4769",
            "fax_number": "307-742-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 BOSWELL DR",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705453",
            "telephone_number": "307-851-9736",
            "fax_number": "307-742-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "BRENDA",
        "middle_name": "JEAN",
        "credential": "MS, NCC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WY",
            "license": "LPC #1214",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "LPC #1214",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calmer Waters Counseling LLC
• Josh Campbell
• Kathryn Elizabeth Campbell
• Tamara Kim Candelaria
• Taylor Cannefax, PHYSICAL THERAPIST
• Susan Magaret Cannon, APRN-FNP
• Michele Caputo, LPC
• Devin Cardinal
• Mark Steven Carducci, DO
• Care United Medical Center of Laramie, LLC

• Counselor in Laramie, WY
• Providers in Laramie, WY by specialty
• Counselor in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.