Provider Demographics
NPI:1558795849
Name:CANALES-CRUZ, VANESSA (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:CANALES-CRUZ
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12030 BANDERA RD
Mailing Address - Street 2:SUITE 108-J
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4735
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12030 BANDERA RD
Practice Address - Street 2:SUITE 108-J
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-4735
Practice Address - Country:US
Practice Address - Phone:210-201-3278
Practice Address - Fax:210-610-5034
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68910101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional