MEDICARE: SAMIYA CANNON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-25-459994	NC

General Provider Information

NPI Number	:	1427983337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMIYA CANNON

Provider Business Mailing Address
First Line	:	10114 PINTAIL PL APT 1305
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-1930
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10916 EDUCATION WAY APT 1305A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-7125
Country	:	US
Telephone Number	:	919-987-4524
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

Similar Medicare Providers

1679079099 — GOOD STRESS COMPANY PLLC
Practice Location Address:

10150 MALLARD CREEK RD STE 104
CHARLOTTE, NC
28262-4567

Practice Phone: 980-242-7090
Practice Fax: 980-556-7219

1548023930 — LSJ RESILIENCE PROJECT
Practice Location Address:

1905 J N PEASE PL STE 103
CHARLOTTE, NC
28262-4509

Practice Phone: 704-910-0136
Practice Fax:

1437613643 — LSJ COUNSELING AND CLINICAL SERVICES, PLLC
Practice Location Address:

1905 J N PEASE PL STE 103
CHARLOTTE, NC
28262-4509

Practice Phone: 704-910-0136
Practice Fax: 866-800-2456

1891669016 — MICHTORIE MEDLEY
Practice Location Address:

11120 DAVID TAYLOR DR APT 1227
CHARLOTTE, NC
28262-2081

Practice Phone: 843-227-9366
Practice Fax:

1669803060 — MRS. TANJELA SHAVONDA HALL
Practice Location Address:

301 MCCULLOUGH DR STE 400
CHARLOTTE, NC
28262-1336

Practice Phone: 704-615-8827
Practice Fax: 704-599-8760

1215863287 — BRIDGETON SOLUTIONS
Practice Location Address:

1914 J N PEASE PL
CHARLOTTE, NC
28262-4504

Practice Phone: 412-607-3572
Practice Fax: 980-276-3029

Directions to “ SAMIYA CANNON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.