Individual
ELIZABETH CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
655 E LIVINGSTON AVE, COLUMBUS, OH 43205-2618
(614) 722-8200
(614) 722-8422
Mailing address
DEPT 781625, DETROIT, MI 48278-1625
(614) 355-8004
(614) 355-0509
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C1100128
OH
101YP2500X
Professional Counselor
Primary
E.1100128
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0204872
—
OH
05
—
1473276
—
OH
Enumeration date
10/17/2012
Last updated
07/15/2020
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