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Individual

JOHN ROY CANNON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
LPCMH

Contact information

Practice address
117 LARKSPUR RD, NEWARK, DE 19711-6863
(302) 738-9963
(302) 995-2121
Mailing address
117 LARKSPUR RD, NEWARK, DE 19711-6863
(302) 738-9963
(302) 995-2121

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
112
DE
101YM0800X
Mental Health Counselor
Primary
4331
DE
101YP2500X
Professional Counselor
PC-0000008
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1000036893
DE MED. ASSIST. PROGRAM
DE
01
2248072
CIGNA BEHAVIORAL HEALTH
DE
01
254526
COMPSYCH
DE
01
364878
MHN/TRICARE
DE
Enumeration date
04/17/2006
Last updated
09/11/2025
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