Healthcare Provider Details

I. General information

NPI: 1548795339
Provider Name (Legal Business Name): JUSTIN CANTALINI LCMHC, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2017
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1498 WARWOMAN RD
CLAYTON GA
30525-5242
US

IV. Provider business mailing address

1498 WARWOMAN RD
CLAYTON GA
30525-5242
US

V. Phone/Fax

Practice location:
  • Phone: 828-567-3615
  • Fax:
Mailing address:
  • Phone: 828-567-3615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10645
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6578
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: