Provider Demographics
NPI:1922664192
Name:CANTEY, LAWRENCE JR (BSW)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:
Last Name:CANTEY
Suffix:JR
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 CHANDLER AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-6204
Mailing Address - Country:US
Mailing Address - Phone:803-553-4352
Mailing Address - Fax:
Practice Address - Street 1:5867 EHRHARDT RD
Practice Address - Street 2:
Practice Address - City:EHRHARDT
Practice Address - State:SC
Practice Address - Zip Code:29081-9065
Practice Address - Country:US
Practice Address - Phone:805-267-6777
Practice Address - Fax:803-267-2660
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2713104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker