Provider Demographics
NPI:1376095943
Name:COLYER, CANDY A (LCSW)
Entity Type:Individual
Prefix:
First Name:CANDY
Middle Name:A
Last Name:COLYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 SEXTON CT
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-4071
Mailing Address - Country:US
Mailing Address - Phone:606-939-1780
Mailing Address - Fax:
Practice Address - Street 1:4632 STATE ROUTE 1043
Practice Address - Street 2:
Practice Address - City:SOUTH SHORE
Practice Address - State:KY
Practice Address - Zip Code:41175-7661
Practice Address - Country:US
Practice Address - Phone:606-498-4175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2581631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical