Provider Demographics
NPI:1033866025
Name:CANDELORO, DEANNA M (LPC-MHSP, LPCMH)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:M
Last Name:CANDELORO
Suffix:
Gender:F
Credentials:LPC-MHSP, LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 SILVERSIDE ROAD
Mailing Address - Street 2:BAYNARD BUILDING, SUITE 104
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810
Mailing Address - Country:US
Mailing Address - Phone:615-474-8700
Mailing Address - Fax:
Practice Address - Street 1:3411 SILVERSIDE ROAD
Practice Address - Street 2:BAYNARD BUILDING
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810
Practice Address - Country:US
Practice Address - Phone:615-474-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4263101YM0800X
DEPC-0011234101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health