Provider Demographics
NPI:1972660637
Name:CANO, ELEAZAR R (LPC)
Entity Type:Individual
Prefix:MR
First Name:ELEAZAR
Middle Name:R
Last Name:CANO
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 1:411 E JUNE ST
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:TX
Mailing Address - Zip Code:79830-2017
Mailing Address - Country:US
Mailing Address - Phone:432-837-0102
Mailing Address - Fax:432-837-3774
Practice Address - Street 1:411 E JUNE ST
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:TX
Practice Address - Zip Code:79830-2017
Practice Address - Country:US
Practice Address - Phone:432-837-0102
Practice Address - Fax:432-837-3774
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14946101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional