Provider Demographics
NPI:1225108681
Name:CANNON, WILLIAM C (LPC-MHSP)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:CANNON
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 WEXFORD DOWNS LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-8591
Mailing Address - Country:US
Mailing Address - Phone:615-297-4222
Mailing Address - Fax:
Practice Address - Street 1:633 THOMPSON LN
Practice Address - Street 2:SUITE 225
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3616
Practice Address - Country:US
Practice Address - Phone:615-921-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1086101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health