MEDICARE: JOSEPH NICHOLAS CANLAS VALDECANAS

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
1	101YM0800X	Mental Health Counselor	APC002125	PA

General Provider Information

NPI Number	:	1972454148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH NICHOLAS CANLAS VALDECANAS

Provider Business Mailing Address
First Line	:	629 E WATERFRONT DR APT 1205
Second Line	:
City	:	MUNHALL
State	:	PA
Zip	:	15120-5019
Country	:	US
Telephone Number	:	484-207-0555
Fax Number	:

Provider Business Practice Location Address
First Line	:	629 E WATERFRONT DR APT 1205
Second Line	:
City	:	HOMESTEAD
State	:	PA
Zip	:	15120-5019
Country	:	US
Telephone Number	:	484-207-0555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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