Provider Demographics
NPI:1023562196
Name:CANTER, REBECCA L (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:CANTER
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11215 RESEARCH BLVD
Mailing Address - Street 2:APT 1120
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4184
Mailing Address - Country:US
Mailing Address - Phone:512-761-6135
Mailing Address - Fax:
Practice Address - Street 1:11215 RESEARCH BLVD
Practice Address - Street 2:APT 1120
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4184
Practice Address - Country:US
Practice Address - Phone:512-761-6135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-06
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72456101YM0800X
TX13521101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)