DR. KEVIN T CANNON PH.D.
NPI 1023509825
Psychologist - Clinical in Andover, MA

Q: What is Kevin Cannon's NPI number?

The NPI number for Kevin Cannon is 1023509825. It was assigned to this individual provider in the NPPES registry on May 29, 2018.

Q: What is Kevin Cannon's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Cannon was last updated on February 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 29, 2018PECOS EnrolledAccepts Medicare Assignment

3 DUNDEE PARK DR STE 203, ANDOVER, MA 01810(978) 655-2252(978) 296-5594 Get Directions Write a Review

NPPES record last updated: February 13, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Feb 13, 2025, Feb 17, 2023, Dec 15, 2020 and 2 more (5 updates tracked since 2019).

On this page

About Dr. Kevin T Cannon Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEVIN T CANNON PH.D. (NPI 1023509825) is an individual clinical provider in Andover, Massachusetts, licensed in Massachusetts (11371) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1023509825

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. KEVIN T CANNONCredential: PH.D.

Location Address3 DUNDEE PARK DR STE 203Andover, MA 01810-3723

Mailing Address5 Linden StHudson, NH 03051-4781 · (603) 438-3523

Phone(978) 655-2252

Fax(978) 296-5594

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateMay 29, 2018

Last NPPES UpdateFebruary 13, 20255 updates tracked since enumeration

NPPES CertifiedFebruary 13, 2025

✔ NPI 1023509825 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MA · 11371

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedClinical NeuropsychologistTaxonomy 103G00000X · License 11371 (MA)

3 DUNDEE PARK DR STE 203, Andover, MA 01810

Open in Google Maps ↗

Secondary Practice Locations 2

Location 110 Federal St Ste 307Salem, MA 01970-3860 · Phone (617) 758-8485 ext. 126

Location 239 Simon St Ste 5Nashua, NH 03060-3045 · Phone (603) 889-8648

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Harvard Pilgrim Health Care, Taro Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kevin T Cannon Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749703049

PECOS Enrollment IDI20250327001473

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kevin Cannon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Integrated Behavioral Care New England LLC

3.5 mi

Counselor

800 TURNPIKE ST STE 300
North Andover, MA 01845

Reassigned Medicare billing, Massachusetts enrollment
36 clinicians in this Medicare group

NPI 1053185272 (978) 296-5595

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01810 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$177.36 typical visit price

range $58.86 – $177.36

Typical copayment $44.34 (range $14.71 – $44.34)

Most-billed visit code 99205

Established Patient

$103.48 typical visit price

range $19.11 – $144.84

Typical copayment $25.87 (range $4.77 – $36.21)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIANA CASADO

Counselor (Mental Health)