Healthcare Provider Details

I. General information

NPI: 1649587619
Provider Name (Legal Business Name): JULIAN G CANO LCSW-S, BCD, CIMHP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2010
Last Update Date: 10/05/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

374 MDG
APO AP
96328
US

IV. Provider business mailing address

374 MDG
APO AP
96328
US

V. Phone/Fax

Practice location:
  • Phone: 210-850-5818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number59338
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: