Healthcare Provider Details

I. General information

NPI: 1427966746
Provider Name (Legal Business Name): SARAH RUTH CANNON LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 EAGLE CREST DR STE A
EVANSVILLE IN
47715-8262
US

IV. Provider business mailing address

940 WILTSHIRE DR
EVANSVILLE IN
47715-4274
US

V. Phone/Fax

Practice location:
  • Phone: 812-250-9255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88003423A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: