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MRS. SAMANTHA CANNON MSW
NPI 1063841419
Counselor in Tulsa, OK

Active since November 06, 2013PECOS EnrolledAccepts Medicare Assignment
3015 E SKELLY DR, STE. 103, TULSA, OK 74105(918) 712-0859 Get Directions Write a Review

NPPES record last updated: November 6, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Samantha Cannon Msw NPPES

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

MRS. SAMANTHA CANNON MSW (NPI 1063841419) is an individual counselor in Tulsa, Oklahoma and active in the NPI registry since November 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1063841419
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameMRS. SAMANTHA CANNONCredential: MSW
Location Address3015 E SKELLY DR, STE. 103Tulsa, OK 74105-6317
Mailing Address3015 E Skelly Dr, Ste. 103Tulsa, OK 74105-6317
Phone(918) 712-0859
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateNovember 6, 2013
✔ NPI 1063841419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
3015 E SKELLY DR, Tulsa, OK 74105
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Other Identifiers 1

Medicaid100746170GOK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma, Medica, Mending Health and more.Insurance ›

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

Mrs. Samantha Cannon Msw 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 ID7517247422
PECOS Enrollment IDI20161212001765
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.

MRS. CONSTANCE VERNETTA ALEXANDER M.A., LMFT
Marriage & Family Therapist
3015 E SKELLY DR, 211-1
TULSA, OK 74105
Tulsa County (918) 884-8255
LAUREL DIANE SMITH
Counselor
3015 E SKELLY DR, SUITE 390
TULSA, OK 74105
Tulsa County (918) 665-0208
WHITNEY LEIGHANN LAHANN
Counselor
3015 E SKELLY DR, SUITE 103
TULSA, OK 74105
Tulsa County (918) 712-0859
JAYNE ANN WILLAMSON
Counselor
3015 E SKELLY DR, SUITE 103
TULSA, OK 74105
Tulsa County (918) 712-0859
DANNY DANIELS
Counselor (Mental Health)
3015 E SKELLY DR, SUITE 103
TULSA, OK 74105
Tulsa County (918) 712-0859
JANEE' WILLIAMS
Counselor
3015 E SKELLY DR, SUITE 103
TULSA, OK 74105
Tulsa County (918) 712-0859
NANCY WILSON
Peer Specialist
3015 E SKELLY DR, SUITE 103
TULSA, OK 74105
Tulsa County (918) 712-0859
MR. MITCHELL LEE HUTCHINSON R.N.
Counselor (Professional)
3015 E SKELLY DR, SUITE 103
TULSA, OK 74105
Tulsa County (918) 388-6447

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 Samantha Cannon's NPI number?

The NPI number for Samantha Cannon is 1063841419. It was assigned to this individual provider in the NPPES registry on November 6, 2013.

Where is Samantha Cannon located?

Samantha Cannon practices at 3015 E Skelly Dr Ste. 103, Tulsa, OK 74105. The listed phone number is (918) 712-0859.

What is Samantha Cannon's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Samantha Cannon enrolled in Medicare?

Yes. Samantha 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.

What insurance does Samantha Cannon accept?

Health plans from Blue Cross and Blue Shield of Oklahoma, Medica, Mending Health, Oscar Insurance Company and UnitedHealthcare list Samantha Cannon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samantha Cannon was last updated on November 6, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.