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NPI 1871775338

NPI 1871775338 : THOMAS E CANNON LCSW : HAMMOND, LA

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General NPI Number Information
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    NPI Number           |    1871775338
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    Entity Type          |    Individual 
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    Provider Name        |    THOMAS E CANNON LCSW
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/27/2007
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    Last Update Date     |    12/02/2025
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Provider Practice Location Address
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    Address Line         |    835 PRIDE DR STE B 
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    City                 |    HAMMOND
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    State                |    LA
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    Zip                  |    70401-9527
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    Country              |    US
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    Telephone            |    985-543-4730
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    Fax                  |    985-543-4817
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Provider Business Mailing Address
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    Address Line         |    835 PRIDE DR STE B 
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    City                 |    HAMMOND
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    State                |    LA
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    Zip                  |    70401-9527
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    Country              |    US
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    Telephone            |    985-543-4730
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    Fax                  |    985-543-4817
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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