Provider Demographics
NPI:1093506115
Name:CANTU, BRANDY BEASLEY (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:BEASLEY
Last Name:CANTU
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 882
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:79250-0882
Mailing Address - Country:US
Mailing Address - Phone:806-983-9895
Mailing Address - Fax:
Practice Address - Street 1:6438 98TH ST STE 100
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-5469
Practice Address - Country:US
Practice Address - Phone:806-403-1003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX98722101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor