| Cannenta Center For Healing And Empowerment Llc | |
|
15851 Dallas Pkwy Addison TX 75001-3369 | |
| (214) 267-9556 | |
| Not Available |
| Full Name | Cannenta Center For Healing And Empowerment Llc |
|---|---|
| Speciality | Social Worker |
| Location | 15851 Dallas Pkwy, Addison, Texas |
| Authorized Official Name and Position | Leticia L Cavazos (FOUNDER/CEO) |
| Authorized Official Contact | 2142678946 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cannenta Center For Healing And Empowerment Llc 15851 Dallas Pkwy Ste 600 Addison TX 75001-6030 Ph: (214) 267-9556 | Cannenta Center For Healing And Empowerment Llc 15851 Dallas Pkwy Addison TX 75001-3369 Ph: (214) 267-9556 |
| NPI Number | 1629647318 |
|---|---|
| Provider Enumeration Date | 06/17/2021 |
| Last Update Date | 10/12/2023 |
| Certification Date | 09/20/2023 |
| Medicare PECOS PAC ID | 9739566795 |
|---|---|
| Medicare Enrollment ID | O20220512000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629647318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Leticia L Cavazos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457924169 PECOS PAC ID: 8729465786 Enrollment ID: I20220512000807 |
| Provider Name | Brenda Zavala |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194428896 PECOS PAC ID: 7719342039 Enrollment ID: I20230420000776 |
| Provider Name | Britany Dawn Myers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174259626 PECOS PAC ID: 3375900871 Enrollment ID: I20230526001198 |
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