Provider Demographics
NPI:1194993964
Name:CANTLEY, T. STEVEN (LSW)
Entity type:Individual
Prefix:MR
First Name:T.
Middle Name:STEVEN
Last Name:CANTLEY
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:MR
Other - First Name:THOMAS
Other - Middle Name:S
Other - Last Name:CANTLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:115 PRIVATE RD. 977
Mailing Address - Street 2:
Mailing Address - City:PEDRO
Mailing Address - State:OH
Mailing Address - Zip Code:45659
Mailing Address - Country:US
Mailing Address - Phone:740-534-1386
Mailing Address - Fax:740-534-1497
Practice Address - Street 1:115 PRIVATE RD. 977
Practice Address - Street 2:
Practice Address - City:PEDRO
Practice Address - State:OH
Practice Address - Zip Code:45659
Practice Address - Country:US
Practice Address - Phone:740-534-1386
Practice Address - Fax:740-534-1497
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0031730104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker