Individual
MS. CATHLYN CAROLE CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C. MHSP
Contact information
Practice address
114 E UNAKA AVE, JOHNSON CITY, TN 37601-4624
(865) 241-1408
Mailing address
1903 SINKING CREEK RD APT 2, JOHNSON CITY, TN 37604-7822
(423) 418-2400
(423) 282-0223
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC 00511
TN
101YM0800X
Mental Health Counselor
LPC 5511
SC
101YP2500X
Professional Counselor
Primary
001551
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508371
—
TN
01
—
2500701
BLUECARE/TENNCARE
TN
01
—
4078991
BCBS COMMERCIAL
TN
01
—
59932800
MAGELLAN BEHAVIORAL HEALTH
TN
Enumeration date
03/29/2007
Last updated
11/27/2023
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