Healthcare Provider Details

I. General information

NPI: 1164950473
Provider Name (Legal Business Name): MICHAEL CANTON MED,LPCC,LCMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 N MARKET ST STE 300
ASHEVILLE NC
28801-2924
US

IV. Provider business mailing address

29 N MARKET ST STE 300
ASHEVILLE NC
28801-2924
US

V. Phone/Fax

Practice location:
  • Phone: 310-663-9517
  • Fax: 828-579-2757
Mailing address:
  • Phone: 310-663-9517
  • Fax: 828-579-2757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number19873
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.1901093
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: