ALICIA CANNON PH.D.
NPI 1316236326
Clinical Neuropsychologist in Baltimore, MD

Q: What is Alicia Cannon's NPI number?

The NPI number for Alicia Cannon is 1316236326. It was assigned to this individual provider in the NPPES registry on March 30, 2011. The provider is also known as Alicia Fields Ph.D..

Q: What is Alicia Cannon's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Alicia Cannon was last updated on December 28, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 30, 2011PECOS Enrolled

1750 E FAIRMOUNT AVE, BALTIMORE, MD 21231(443) 923-4442(443) 923-4403 Get Directions Write a Review

NPPES record last updated: December 28, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Alicia Cannon Ph.d. NPPES

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

ALICIA CANNON PH.D. (NPI 1316236326) is an individual clinical neuropsychologist in Baltimore, Maryland, licensed in Maryland (05106) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316236326

Entity TypeIndividualFemale

Primary Taxonomy103G00000X

Provider Legal NameALICIA CANNONCredential: PH.D.

Location Address1750 E FAIRMOUNT AVEBaltimore, MD 21231-1534

Mailing Address1750 E Fairmount AveBaltimore, MD 21231-1534 · (443) 923-4442 · Fax (443) 923-4403

Phone(443) 923-4442

Fax(443) 923-4403

Sole ProprietorNo

Enumeration DateMarch 30, 2011

Last NPPES UpdateDecember 28, 2023

NPPES CertifiedDecember 28, 2023

✔ NPI 1316236326 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

Licenses✔ Licensed in MD · 05106✔ Licensed in VA · 0810004365

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 05106 (MD), 0810004365 (VA)

1750 E FAIRMOUNT AVE, Baltimore, MD 21231

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Other Names 1

Former Name (1)Alicia Fields Ph.d.

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alicia Cannon Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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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.

YVONNE CARUSO RN

Registered Nurse