Provider Demographics
NPI:1487111027
Name:CANTU, TAMMY (LPC)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:CANTU
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 LEXINGTON PASS
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:78133-3268
Mailing Address - Country:US
Mailing Address - Phone:210-834-5017
Mailing Address - Fax:
Practice Address - Street 1:543 LEXINGTON PASS
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:TX
Practice Address - Zip Code:78133-3268
Practice Address - Country:US
Practice Address - Phone:210-834-5017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-01
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80160101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health