Provider Demographics
NPI:1881350007
Name:CANEZ, CYNTHIA (LPC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:CANEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2177 E WARNER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-3511
Mailing Address - Country:US
Mailing Address - Phone:480-573-0000
Mailing Address - Fax:
Practice Address - Street 1:1490 S PRICE RD STE 107
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-6606
Practice Address - Country:US
Practice Address - Phone:480-236-8202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LPC23472101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLAC-19177OtherLAC LICENCE NUMBER