Cannon, Jill
Cannon, Jill is an sole proprietor health care provider with primary practice located at 130 Allison Rd , Katonah NY 10536-3430. She recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Group Psychotherapy. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Cannon, Jill can be contacted via phone (914) 401-9010.Contact Information
Primary practice address
130 Allison Rd
Katonah NY 10536-3430
Phone: (914) 401-9010
Fax: (914) 401-9009
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X | 0190571 | New York |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | R#019571 | New York |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 0190571 | New York |
| Behavioral Health & Social Service Providers / Family | 103TF0000X | 0190571 | New York |
| Behavioral Health & Social Service Providers / Forensic | 103TF0200X | 0190571 | New York |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 0190571 | New York |
| Behavioral Health & Social Service Providers / Group Psychotherapy | 103TP2701X | 019571 | New York |
Profile Details
| NPI number | 1225003379 |
|---|---|
| LBN Legal business name | Cannon, Jill |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 22nd, 2006 |
| Last updated | Oct 23rd, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225003379 | NPPES |
| Other | 140019057NY01 | ANTHEM | |
| Other | 135497 | ANTHEM |
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