Provider Demographics
NPI:1588067490
Name:CANALES, CLAUDIA GRACE (PHD)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:GRACE
Last Name:CANALES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 FLINT LOCK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-2481
Mailing Address - Country:US
Mailing Address - Phone:785-452-4930
Mailing Address - Fax:785-452-4932
Practice Address - Street 1:730 HOLLY LN
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-8452
Practice Address - Country:US
Practice Address - Phone:785-452-4930
Practice Address - Fax:785-452-4932
Is Sole Proprietor?:No
Enumeration Date:2014-10-06
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1347103TC0700X
KS2554103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201148760AMedicaid