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NPI Code Detail

MEDICARE: JUSTIN GEORGE CANCEL MSW

MEDICARE: JUSTIN GEORGE CANCEL MSW
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 Worker

General Provider Information

NPI Number : 1750957817
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN GEORGE CANCEL MSW
Provider Business Mailing Address
First Line : 1400 WESTINGHOUSE RD APT 2316
Second Line :
City : GEORGETOWN
State : TX
Zip : 78626-2371
Country : US
Telephone Number : 512-748-4584
Fax Number :
Provider Business Practice Location Address
First Line : 1101 CAMINO LA COSTA
Second Line :
City : AUSTIN
State : TX
Zip : 78752-3930
Country : US
Telephone Number : 512-478-4939
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2021
Last Update Date : 02/03/2026

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Directions to “ JUSTIN GEORGE CANCEL MSW” Practice Location

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