JUSTIN DEANDRE CANNON LCSW
NPI 1639826936
Social Worker - Clinical in Houston, TX

Q: What is Justin Cannon's NPI number?

The NPI number for Justin Cannon is 1639826936. It was assigned to this individual provider in the NPPES registry on March 7, 2022.

Q: What is Justin Cannon's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Justin Cannon was last updated on October 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since March 07, 2022PECOS EnrolledAccepts Medicare Assignment

4131 S BRAESWOOD BLVD, HOUSTON, TX 77025(713) 667-9336(713) 667-3619 Get Directions Write a Review

NPPES record last updated: October 9, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 9, 2024, Mar 7, 2022 (2 updates tracked since 2022).

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About Justin Deandre Cannon Lcsw NPPES

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

JUSTIN DEANDRE CANNON LCSW (NPI 1639826936) is an individual clinical provider in Houston, Texas, licensed in Texas (104745) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1639826936

Entity TypeIndividualMale

Primary Taxonomy1041C0700X

Provider Legal NameJUSTIN DEANDRE CANNONCredential: LCSW

Location Address4131 S BRAESWOOD BLVDHouston, TX 77025-3392

Mailing Address4131 S Braeswood BlvdHouston, TX 77025-3392 · (713) 667-9336 · Fax (713) 667-3619

Phone(713) 667-9336

Fax(713) 667-3619

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateMarch 7, 2022

Last NPPES UpdateOctober 9, 20242 updates tracked since enumeration

NPPES CertifiedOctober 9, 2024

✔ NPI 1639826936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in TX · 104745

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Also ListedSocial WorkerTaxonomy 104100000X · License 104745 (TX)

4131 S BRAESWOOD BLVD, Houston, TX 77025

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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

Justin Deandre Cannon Lcsw 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 ID4284175183

PECOS Enrollment IDI20240918004648

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 Justin Cannon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Jewish Family Service

Same address

Clinical

4131 S BRAESWOOD BLVD
Houston, TX 77025

Reassigned Medicare billing, Texas enrollment
14 clinicians in this Medicare group

NPI 1245387919 (713) 667-9336

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 77025 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

$0.00 typical visit price

range $58.24 – $176.98

Typical copayment $0.00 (range $14.56 – $44.24)

Most-billed visit code NA

Established Patient

$72.62 typical visit price

range $18.60 – $143.93

Typical copayment $18.15 (range $4.65 – $35.98)

Most-billed visit code 99213

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 20

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

NICHOLAS TOFILON LCSW

Social Worker (Clinical)