MS. MARY SPROWL CANNON M.A., LMFT
NPI 1053600825
Marriage & Family Therapist in San Jose, CA

Active since April 01, 2011PECOS EnrolledAccepts Medicare Assignment
1101 S WINCHESTER BLVD, SUITE A101, SAN JOSE, CA 95128(408) 859-4983 Get Directions Write a Review

NPPES record last updated: April 1, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 1, 2021, Dec 2, 2020, Feb 6, 2017 (3 updates tracked since 2017).

About Ms. Mary Sprowl Cannon M.a., Lmft NPPES

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

MS. MARY SPROWL CANNON M.A., LMFT (NPI 1053600825) is an individual marriage & family therapist in San Jose, California, licensed in California (MFC40685) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1053600825
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameMS. MARY SPROWL CANNONCredential: M.A., LMFT
Location Address1101 S WINCHESTER BLVD, SUITE A101San Jose, CA 95128-3901
Mailing Address1101 S Winchester Blvd Ste A101San Jose, CA 95128-3914 · (408) 859-4983
Sole ProprietorYes
Medical School CMSOtherGraduated 2000
Enumeration DateApril 1, 2011
Last NPPES UpdateApril 1, 20213 updates tracked since enumeration
NPPES CertifiedApril 1, 2021
NPI 1053600825 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License Licensed in CA · MFC40685
Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

1101 S WINCHESTER BLVD, San Jose, CA 95128

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ms. Mary Sprowl Cannon M.a., Lmft 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 ID1759806649
PECOS Enrollment IDI20250423002806
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.

Other Providers at the Same Location NPPES 20

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

Naturopath
1101 S WINCHESTER BLVD, E157
SAN JOSE, CA 95128
Speech-Language Pathologist
1101 S WINCHESTER BLVD
SAN JOSE, CA 95128
Legal Medicine
1101 S WINCHESTER BLVD, SUITE I-207
SAN JOSE, CA 95128
Speech-Language Pathologist
1101 S WINCHESTER BLVD, SUITE F168
SAN JOSE, CA 95128
Acupuncturist
1101 S WINCHESTER BLVD, L-241
SAN JOSE, CA 95128
Marriage & Family Therapist
1101 S WINCHESTER BLVD, H-187
SAN JOSE, CA 95128
Naturopath
1101 S WINCHESTER BLVD, STE E157
SAN JOSE, CA 95128
Social Worker (Clinical)
1101 S WINCHESTER BLVD, STE. M258
SAN JOSE, CA 95128

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Cannon's NPI number?

The NPI number for Mary Cannon is 1053600825. It was assigned to this individual provider in the NPPES registry on April 1, 2011.

Where is Mary Cannon located?

Mary Cannon practices at 1101 S Winchester Blvd Suite A101, San Jose, CA 95128. The listed phone number is (408) 859-4983.

What is Mary Cannon's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Mary Cannon enrolled in Medicare?

Yes. Mary Cannon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Mary Cannon was last updated on April 1, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.