Bruce A Cannon, MA, LPC
Counselor, Professional in Livonia, MI. Individual provider (NPI-1).
NPI number1982305009
StatusActive
Last updated in NPPESJul 23, 2025
Details
- NPI
- 1982305009
- Entity type
- Individual (NPI-1)
- Name
- Bruce A Cannon
- Credential
- MA, LPC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 15, 2023
- Certification date
- Jul 23, 2025
- Last updated
- Jul 23, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - MENTAL HEALTH COUNSELOR
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 6401224976 | MI | Yes |
Practice location
38701 7 Mile Rd Ste 473Livonia, MI 48152-1091
Phone 734-335-8799
Mailing address
6193 Porteridge LnCanton, MI 48187-2626
Phone 734-604-3454
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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