Provider Demographics
NPI:1174293849
Name:CANTU, LINDA (LPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:CANTU
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 E GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2915
Mailing Address - Country:US
Mailing Address - Phone:956-600-7123
Mailing Address - Fax:956-600-7101
Practice Address - Street 1:423 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2915
Practice Address - Country:US
Practice Address - Phone:956-600-7123
Practice Address - Fax:956-600-7101
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15272101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional