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Mr. King Edward Cannon JR.
Addiction (Substance Use Disorder) Counselor in Sorrento, Louisiana
NPI 1821791336

King Edward Cannon JR. is an Addiction (Substance Use Disorder) Counselor based in Sorrento, LA and is specialized in Addiction (Substance Use Disorder). King Edward Cannon JR. practices in Sorrento, LA. The NPI Number for King Edward Cannon JR. is 1821791336 and holds a License No. (Louisiana).

The current practice location address for King Edward Cannon JR. is 7384 John Leblanc Blvd, Sorrento, LA and can be reached out via phone at 225-310-2600.

Location: 7384 John Leblanc Blvd, Sorrento, LA, 70778-3231
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821791336
Provider Name
King Edward Cannon JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
7384 John Leblanc Blvd, Sorrento, LA, 70778-3231
Phone Number
225-310-2600
Fax Number
Provider Enumeration Date
03/23/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
7384 John Leblanc Blvd
City
Sorrento
State
Louisiana
Zip
70778-3231
Phone Number
225-310-2600
Fax Number
person
Provider Business Mailing Address Details
Address
7384 John Leblanc Blvd
City
Sorrento
State
Louisiana
Zip
70778-3231
Phone Number
225-310-2600
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
175T00000X (Louisiana)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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