Provider Demographics
NPI:1275809238
Name:CANO, JOSE G JR (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:G
Last Name:CANO
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:894 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VAN
Mailing Address - State:TX
Mailing Address - Zip Code:75790-2944
Mailing Address - Country:US
Mailing Address - Phone:903-805-2903
Mailing Address - Fax:
Practice Address - Street 1:894 E MAIN ST
Practice Address - Street 2:
Practice Address - City:VAN
Practice Address - State:TX
Practice Address - Zip Code:75790-2944
Practice Address - Country:US
Practice Address - Phone:903-805-2903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60463101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional