Provider Demographics
NPI:1407421134
Name:LAING, CANDACE KADIAN MOREEN (RMHCI, MS, BS)
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:KADIAN MOREEN
Last Name:LAING
Suffix:
Gender:F
Credentials:RMHCI, MS, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4555 JUNIPER GRAND LOOP APT 101
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-4356
Mailing Address - Country:US
Mailing Address - Phone:407-455-3422
Mailing Address - Fax:
Practice Address - Street 1:6732 WOODLAKE DR APT 315
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-3522
Practice Address - Country:US
Practice Address - Phone:407-455-3422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
FLIMH21406101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty