Provider Demographics
NPI:1477752244
Name:CANTER, STEWART JAY (LPC)
Entity Type:Individual
Prefix:
First Name:STEWART
Middle Name:JAY
Last Name:CANTER
Suffix:
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 1:45 ELEVACRES RD
Mailing Address - Street 2:
Mailing Address - City:LEICESTER
Mailing Address - State:NC
Mailing Address - Zip Code:28748-7440
Mailing Address - Country:US
Mailing Address - Phone:828-712-5759
Mailing Address - Fax:
Practice Address - Street 1:45 ELEVACRES RD
Practice Address - Street 2:
Practice Address - City:LEICESTER
Practice Address - State:NC
Practice Address - Zip Code:28748-7440
Practice Address - Country:US
Practice Address - Phone:828-712-5759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4316101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102116Medicaid