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NPI Code Detail

MEDICARE: CELINA CANTU LCSW

MEDICARE: CELINA CANTU LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker149020973IL
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1134507247
Entity Type Code : Individual
Provider Name (Legal Business Name) : CELINA CANTU LCSW
Provider Business Mailing Address
First Line : 1220 S WOOD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1202
Country : US
Telephone Number : 312-413-3282
Fax Number :
Provider Business Practice Location Address
First Line : 3240 W DIVISION ST
Second Line :
City : CHICAGO
State : IL
Zip : 60651-2405
Country : US
Telephone Number : 312-413-7425
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2015
Last Update Date : 10/31/2022

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