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General NPI Number Information
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NPI Number | 1194119131
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Entity Type | Organization
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Legal Business Name | CANO FAMILY SERVICES, PLLC
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 05/01/2022
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Provider Practice Location Address
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Address Line | 1909 J N PEASE PL STE 101
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City | CHARLOTTE
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State | NC
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Zip | 28262-4509
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Country | US
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Telephone | 980-313-3020
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Fax | 704-980-8023
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Provider Business Mailing Address
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Address Line | 2812 ISLAND POINT DR NW
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City | CONCORD
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State | NC
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Zip | 28027-2537
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Country | US
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Telephone | 980-621-8401
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANGELA M CANO-JOHNSON
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Credential | LCSW
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Telephone | 980-621-8401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C009256
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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