Provider Demographics
NPI:1609111368
Name:CANO-JOHNSON, ANGELA MARIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:MARIA
Last Name:CANO-JOHNSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2812 ISLAND POINT DR NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-2537
Mailing Address - Country:US
Mailing Address - Phone:980-621-8401
Mailing Address - Fax:704-980-8023
Practice Address - Street 1:1977 J N PEASE PL
Practice Address - Street 2:SUITE 101
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4508
Practice Address - Country:US
Practice Address - Phone:980-621-8401
Practice Address - Fax:704-980-8023
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0092561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical