Provider Demographics
NPI:1417186362
Name:CANEZ, JULES JASON (LCSW-R; MSW)
Entity Type:Individual
Prefix:MR
First Name:JULES
Middle Name:JASON
Last Name:CANEZ
Suffix:
Gender:M
Credentials:LCSW-R; MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BEADART PL
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12538-1218
Mailing Address - Country:US
Mailing Address - Phone:518-567-2225
Mailing Address - Fax:845-868-3124
Practice Address - Street 1:10 BEADART PL
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:12538-1218
Practice Address - Country:US
Practice Address - Phone:518-567-2225
Practice Address - Fax:845-868-3124
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73 0711921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical