Individual provider · Type 1 NPI
Mary Elizabeth Cannon, LMHC, CRC, CASAC
Mental Health Counselor · Montauk, NY
NPI number
1164593661
Active
Practice location
69 Surfside Ave
Montauk, NY 11954-0896
Fax (631) 238-5060
Mailing address
PO Box 1300, 69 Surfside Ave
Montauk, NY 11954-0896
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 002860-1 (NY) |
Mental Health Counselor: Definition to come...
About NPI 1164593661
Mary Elizabeth Cannon, LMHC, CRC, CASAC's National Provider Identifier is 1164593661, issued on Nov 13, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Montauk, NY. The record was last updated on Jul 8, 2007.