Provider Demographics
NPI:1093236663
Name:CHUYOU-CAMPBELL, CANDACE (MS, LPC, RPT)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:CHUYOU-CAMPBELL
Suffix:
Gender:F
Credentials:MS, LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W LOUISIANA ST STE 206
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-4456
Mailing Address - Country:US
Mailing Address - Phone:469-712-6587
Mailing Address - Fax:
Practice Address - Street 1:101 W LOUISIANA ST STE 206
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-4456
Practice Address - Country:US
Practice Address - Phone:469-712-6587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68419101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional