Provider Demographics
NPI:1902233547
Name:CANNON, BARBARA EMILY (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:EMILY
Last Name:CANNON
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-1401
Mailing Address - Country:US
Mailing Address - Phone:518-242-4731
Mailing Address - Fax:518-242-4747
Practice Address - Street 1:391 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1401
Practice Address - Country:US
Practice Address - Phone:518-242-4731
Practice Address - Fax:518-242-4747
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004608101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health